MEDICARE: VALRIE BROWN-PAYNE 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	387813-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588179154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALRIE BROWN-PAYNE RN

Provider Business Mailing Address
First Line	:	4368 DE REIMER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-1820
Country	:	US
Telephone Number	:	347-200-5857
Fax Number	:

Provider Business Practice Location Address
First Line	:	4368 DE REIMER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-1820
Country	:	US
Telephone Number	:	347-200-5857
Fax Number	:

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

Provider Enumeration Date	:	12/05/2017
Last Update Date	:	12/05/2017

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