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NPI Code Detail

MEDICARE: NICOLE ACEVEDO

MEDICARE:   NICOLE  ACEVEDO
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1467831636
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE ACEVEDO
Provider Business Mailing Address
First Line : 7032 69TH PL
Second Line :
City : GLENDALE
State : NY
Zip : 11385-6642
Country : US
Telephone Number : 347-993-7670
Fax Number :
Provider Business Practice Location Address
First Line : 7032 69TH PL
Second Line :
City : GLENDALE
State : NY
Zip : 11385-6642
Country : US
Telephone Number : 347-993-7670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2015
Last Update Date : 05/21/2015

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Directions to “ NICOLE ACEVEDO ” Practice Location

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