MEDICARE: GUERLY JOSEPH 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
1	163W00000X	Registered Nurse	252028	MA

General Provider Information

NPI Number	:	1487896445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUERLY JOSEPH RN

Provider Business Mailing Address
First Line	:	32 NOTTINGHAM ST
Second Line	:
City	:	DORCHESTER
State	:	MA
Zip	:	02121-3818
Country	:	US
Telephone Number	:	617-606-0358
Fax Number	:

Provider Business Practice Location Address
First Line	:	32 NOTTINGHAM ST
Second Line	:
City	:	DORCHESTER
State	:	MA
Zip	:	02121-3818
Country	:	US
Telephone Number	:	617-606-0358
Fax Number	:	617-442-9330

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

Provider Enumeration Date	:	04/06/2009
Last Update Date	:	02/14/2016

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