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NPI Code Detail

MEDICARE: IRYL FELICIDARIO

MEDICARE: IRYL FELICIDARIO
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
1171W00000XContractorAS630066532MI
2171W00000XContractorAS630079486MI
3171W00000XContractorAS500363588MI
4171W00000XContractorAS500012029MI

General Provider Information

NPI Number : 1689100273
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRYL FELICIDARIO
Provider Business Mailing Address
First Line : 2033 HARNED DR
Second Line :
City : TROY
State : MI
Zip : 48085-1046
Country : US
Telephone Number : 248-689-2056
Fax Number : 248-689-4283
Provider Business Practice Location Address
First Line : 2033 HARNED DR
Second Line :
City : TROY
State : MI
Zip : 48085-1046
Country : US
Telephone Number : 248-689-2056
Fax Number : 248-689-4283
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2017
Last Update Date : 07/29/2019

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Directions to “ IRYL FELICIDARIO ” Practice Location

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