MEDICARE: MRS. MARY ELIZABETH BRESCIA RN, BSN

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	328025-1	NY
2	163WH0200X	Home Health Registered Nurse	328025-1	NY

General Provider Information

NPI Number	:	1548553852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY ELIZABETH BRESCIA RN, BSN

Provider Business Mailing Address
First Line	:	1142 RIDGEBURY RD
Second Line	:
City	:	NEW HAMPTON
State	:	NY
Zip	:	10958-4858
Country	:	US
Telephone Number	:	845-374-2901
Fax Number	:

Provider Business Practice Location Address
First Line	:	1142 RIDGEBURY RD
Second Line	:
City	:	NEW HAMPTON
State	:	NY
Zip	:	10958-4858
Country	:	US
Telephone Number	:	845-374-2901
Fax Number	:

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

Provider Enumeration Date	:	05/18/2011
Last Update Date	:	05/18/2011

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