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NPI Code Detail

MEDICARE: ROUDEMA SHEMAIA ZEPHYRIN

MEDICARE:   ROUDEMA SHEMAIA ZEPHYRIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse3311841NY

General Provider Information

NPI Number : 1336641729
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROUDEMA SHEMAIA ZEPHYRIN
Provider Business Mailing Address
First Line : 1190 E 91ST ST FL 1
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-3913
Country : US
Telephone Number : 754-715-2488
Fax Number :
Provider Business Practice Location Address
First Line : 1190 E 91ST ST FL 1
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-3913
Country : US
Telephone Number : 754-715-2488
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2018
Last Update Date : 03/01/2018

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Directions to “ ROUDEMA SHEMAIA ZEPHYRIN ” Practice Location

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