MEDICARE: MISS SHIFRA STURM R.N.

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	632317	NY

General Provider Information

NPI Number	:	1780994525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SHIFRA STURM R.N.

Provider Business Mailing Address
First Line	:	5 WISHERS LN
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-1717
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 WISHERS LN
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-1717
Country	:	US
Telephone Number	:	845-362-4850
Fax Number	:

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

Provider Enumeration Date	:	10/14/2010
Last Update Date	:	10/14/2010

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