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NPI Code Detail

MEDICARE: ITZEL JEAN-LOUIS

MEDICARE: ITZEL JEAN-LOUIS
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
1163W00000XRegistered Nurse691938NY

General Provider Information

NPI Number : 1629505284
Entity Type Code : Individual
Provider Name (Legal Business Name) : ITZEL JEAN-LOUIS
Provider Business Mailing Address
First Line : 22 CHAPEL ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-1903
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 494 DUMONT AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11207-5017
Country : US
Telephone Number : 718-260-2920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2017
Last Update Date : 05/15/2017

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Directions to “ ITZEL JEAN-LOUIS ” Practice Location

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