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NPI Code Detail

MEDICARE: JENNY VERCELES LPN, RN

MEDICARE:   JENNY  VERCELES  LPN, 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
1163W00000XRegistered Nurse619870NY
2164W00000XLicensed Practical Nurse295321NY

General Provider Information

NPI Number : 1447668132
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNY VERCELES LPN, RN
Provider Business Mailing Address
First Line : 520 W VALLEY STREAM BLVD
Second Line :
City : VALLEY STREAM
State : NY
Zip : 11580-5127
Country : US
Telephone Number : 516-754-0568
Fax Number :
Provider Business Practice Location Address
First Line : 520 W VALLEY STREAM BLVD
Second Line :
City : VALLEY STREAM
State : NY
Zip : 11580-5127
Country : US
Telephone Number : 516-754-0568
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2014
Last Update Date : 07/26/2014

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Directions to “ JENNY VERCELES LPN, RN” Practice Location

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