MEDICARE: DR. NADIA DUVILAIRE M.D

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	207Q00000X	Family Medicine Physician	217621	NY
2	207Q00000X	Family Medicine Physician	MD16438	RI

General Provider Information

NPI Number	:	1619914413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NADIA DUVILAIRE M.D

Provider Business Mailing Address
First Line	:	823 MAIN ST
Second Line	:
City	:	HOPE VALLEY
State	:	RI
Zip	:	02832-1920
Country	:	US
Telephone Number	:	401-539-2461
Fax Number	:	401-539-2490

Provider Business Practice Location Address
First Line	:	413 E 120TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-3602
Country	:	US
Telephone Number	:	212-410-7940
Fax Number	:	212-410-9236

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	12/17/2018

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