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NPI Code Detail

MEDICARE: JESSICA ASHLEY IANUZI

MEDICARE:   JESSICA ASHLEY IANUZI
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
1374U00000XHome Health Aide00174954NY

General Provider Information

NPI Number : 1487087425
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA ASHLEY IANUZI
Provider Business Mailing Address
First Line : 217 AMBER BEACH RD
Second Line :
City : MARIETTA
State : NY
Zip : 13110-3259
Country : US
Telephone Number : 315-283-0672
Fax Number :
Provider Business Practice Location Address
First Line : 217 AMBER BEACH RD
Second Line :
City : MARIETTA
State : NY
Zip : 13110-3259
Country : US
Telephone Number : 315-283-0672
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2013
Last Update Date : 08/13/2013

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Directions to “ JESSICA ASHLEY IANUZI ” Practice Location

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