MEDICARE: OKSANA GLINCHUK RN

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
1	163W00000X	Registered Nurse	596154	NY

General Provider Information

NPI Number	:	1376796029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OKSANA GLINCHUK RN

Provider Business Mailing Address
First Line	:	11 RICHARD ST
Second Line	:
City	:	SLOATSBURG
State	:	NY
Zip	:	10974-2407
Country	:	US
Telephone Number	:	845-753-2048
Fax Number	:	845-753-2430

Provider Business Practice Location Address
First Line	:	11 RICHARD ST
Second Line	:
City	:	SLOATSBURG
State	:	NY
Zip	:	10974-2407
Country	:	US
Telephone Number	:	845-753-2048
Fax Number	:	845-753-2430

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	10/28/2008

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