MEDICARE: RUSHELLE OSHEA BERNETT

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	363LF0000X	Family Nurse Practitioner	F344916-01	NY

General Provider Information

NPI Number	:	1669007928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUSHELLE OSHEA BERNETT

Provider Business Mailing Address
First Line	:	14722 231ST ST
Second Line	:
City	:	SPRINGFIELD GARDENS
State	:	NY
Zip	:	11413-4428
Country	:	US
Telephone Number	:	718-737-1433
Fax Number	:

Provider Business Practice Location Address
First Line	:	265 W PARK AVE
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3222
Country	:	US
Telephone Number	:	516-431-3600
Fax Number	:

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

Provider Enumeration Date	:	03/06/2020
Last Update Date	:	03/06/2020

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Directions to “ RUSHELLE OSHEA BERNETT ” Practice Location

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