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NPI Code Detail

MEDICARE: SPENDYLOVE AGYEMAN RN

MEDICARE: SPENDYLOVE AGYEMAN RN
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 Nurse717236NY

General Provider Information

NPI Number : 1730682345
Entity Type Code : Individual
Provider Name (Legal Business Name) : SPENDYLOVE AGYEMAN RN
Provider Business Mailing Address
First Line : 9728 57TH AVE APT 3M
Second Line :
City : CORONA
State : NY
Zip : 11368-3522
Country : US
Telephone Number : 347-445-1681
Fax Number :
Provider Business Practice Location Address
First Line : 155 DEAN ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11217-2213
Country : US
Telephone Number : 718-694-6700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2018
Last Update Date : 03/10/2018

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