MEDICARE: NAZILA SARA MUNESA D.P.M

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	213ES0103X	Foot & Ankle Surgery Podiatrist	N006386	NY
2	213ES0103X	Foot & Ankle Surgery Podiatrist	25MD00305700	NJ

General Provider Information

NPI Number	:	1710216742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAZILA SARA MUNESA D.P.M

Provider Business Mailing Address
First Line	:	4317 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1337
Country	:	US
Telephone Number	:	917-841-3521
Fax Number	:

Provider Business Practice Location Address
First Line	:	4317 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1337
Country	:	US
Telephone Number	:	917-841-3521
Fax Number	:

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

Provider Enumeration Date	:	12/22/2009
Last Update Date	:	02/03/2011

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