MEDICARE: MS. CLAUDINE DAMIS

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	597199-1	NY

General Provider Information

NPI Number	:	1801145693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CLAUDINE DAMIS

Provider Business Mailing Address
First Line	:	5617 TILDEN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-4819
Country	:	US
Telephone Number	:	347-689-8906
Fax Number	:

Provider Business Practice Location Address
First Line	:	5617 TILDEN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-4819
Country	:	US
Telephone Number	:	347-689-8906
Fax Number	:

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

Provider Enumeration Date	:	09/07/2012
Last Update Date	:	09/07/2012

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