MEDICARE: MRS. ELENA RICCIO PUNZELL R.N.

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	RN313571L	PA

General Provider Information

NPI Number	:	1396984704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELENA RICCIO PUNZELL R.N.

Provider Business Mailing Address
First Line	:	620 MEADOWRIDGE DR
Second Line	:
City	:	ELLWOOD CITY
State	:	PA
Zip	:	16117-6306
Country	:	US
Telephone Number	:	724-752-9562
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 MEADOWRIDGE DR
Second Line	:
City	:	ELLWOOD CITY
State	:	PA
Zip	:	16117-6306
Country	:	US
Telephone Number	:	724-752-9562
Fax Number	:

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

Provider Enumeration Date	:	02/09/2009
Last Update Date	:	02/09/2009

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