MEDICARE: ERWEN E LOPPE RN, BSN

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	163WM0705X	Medical-Surgical Registered Nurse	552257	NY
2	163WS0200X	School Registered Nurse	552257	NY

General Provider Information

NPI Number	:	1689256810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERWEN E LOPPE RN, BSN

Provider Business Mailing Address
First Line	:	955 E 89TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3910
Country	:	US
Telephone Number	:	347-439-7507
Fax Number	:

Provider Business Practice Location Address
First Line	:	955 E 89TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3910
Country	:	US
Telephone Number	:	347-439-7507
Fax Number	:

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

Provider Enumeration Date	:	04/27/2021
Last Update Date	:	04/27/2021

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