MEDICARE: MR. HARRYCHAN RAMU 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	163WH0200X	Home Health Registered Nurse	633414	NY

General Provider Information

NPI Number	:	1639486442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HARRYCHAN RAMU RN

Provider Business Mailing Address
First Line	:	125 STERLING AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07305-1405
Country	:	US
Telephone Number	:	201-536-1055
Fax Number	:

Provider Business Practice Location Address
First Line	:	892 WYCKOFF AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-6116
Country	:	US
Telephone Number	:	718-386-4780
Fax Number	:

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

Provider Enumeration Date	:	09/01/2010
Last Update Date	:	09/01/2010

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