MEDICARE: AIONGA SONYA PEREIRA-EDWARDS R

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	163W00000X	Registered Nurse	660599-1	NY

General Provider Information

NPI Number	:	1750731402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIONGA SONYA PEREIRA-EDWARDS R

Provider Business Mailing Address
First Line	:	2 CHESTER CT
Second Line	:	3F
City	:	BROOKLYN
State	:	NY
Zip	:	11225-4927
Country	:	US
Telephone Number	:	718-809-6271
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 CHESTER CT
Second Line	:	3F
City	:	BROOKLYN
State	:	NY
Zip	:	11225-4927
Country	:	US
Telephone Number	:	718-809-6271
Fax Number	:

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

Provider Enumeration Date	:	06/14/2016
Last Update Date	:	06/14/2016

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