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NPI Code Detail

MEDICARE: KEREN GRACE MELEGRITO

MEDICARE:   KEREN GRACE MELEGRITO
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 NurseRN733356PA

General Provider Information

NPI Number : 1700518420
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEREN GRACE MELEGRITO
Provider Business Mailing Address
First Line : 2108 BORBECK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19152-3725
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2108 BORBECK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19152-3725
Country : US
Telephone Number : 267-232-8285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2022
Last Update Date : 06/30/2022

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Directions to “ KEREN GRACE MELEGRITO ” Practice Location

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