MEDICARE: MISS NADENE CYNTHIA LEWIS 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	522056-1	NY

General Provider Information

NPI Number	:	1801125109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS NADENE CYNTHIA LEWIS R.N.

Provider Business Mailing Address
First Line	:	9506 SCHENCK ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-5428
Country	:	US
Telephone Number	:	718-444-0444
Fax Number	:

Provider Business Practice Location Address
First Line	:	1535 ROCKAWAY PKWY
Second Line	:	RENAISSANCE HOME HEALTH CARE
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4001
Country	:	US
Telephone Number	:	718-649-3670
Fax Number	:	718-649-3671

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

Provider Enumeration Date	:	12/15/2009
Last Update Date	:	12/06/2010

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