MEDICARE: MS. JANET HELEN VANCLEAVE RN, ACNP-CS

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	363LA2100X	Acute Care Nurse Practitioner	F430117-1	NY

General Provider Information

NPI Number	:	1548401870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANET HELEN VANCLEAVE RN, ACNP-CS

Provider Business Mailing Address
First Line	:	1 GUSTAVE LEVY PLACE
Second Line	:	BOX1495
City	:	NEW YORK
State	:	NY
Zip	:	10029-6574
Country	:	US
Telephone Number	:	212-241-7921
Fax Number	:	212-987-1323

Provider Business Practice Location Address
First Line	:	1 GUSTAVE LEVY PLACE
Second Line	:
City	:	NEW YORK CITY
State	:	NY
Zip	:	10029-6574
Country	:	US
Telephone Number	:	212-241-7921
Fax Number	:	212-987-1323

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

Provider Enumeration Date	:	03/17/2009
Last Update Date	:	03/17/2009

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