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NPI Code Detail

MEDICARE: VVINTEROSE THOMPSON L.P.N

MEDICARE: VVINTEROSE THOMPSON L.P.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
1164W00000XLicensed Practical Nurse268261NY

General Provider Information

NPI Number : 1487061057
Entity Type Code : Individual
Provider Name (Legal Business Name) : VVINTEROSE THOMPSON L.P.N
Provider Business Mailing Address
First Line : 4010 DYRE AVE
Second Line :
City : BRONX
State : NY
Zip : 10466-2510
Country : US
Telephone Number : 718-515-3000
Fax Number :
Provider Business Practice Location Address
First Line : 4010 DYRE AVE
Second Line :
City : BRONX
State : NY
Zip : 10466-2510
Country : US
Telephone Number : 718-515-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2014
Last Update Date : 07/16/2014

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