MEDICARE: IVALYN MCWHORTER

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	163WH0200X	Home Health Registered Nurse	58924-01	NY
2	163WH0200X	Home Health Registered Nurse	582492-01	NY

General Provider Information

NPI Number	:	1841098423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVALYN MCWHORTER

Provider Business Mailing Address
First Line	:	1466 ROYCE ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5924
Country	:	US
Telephone Number	:	347-262-3865
Fax Number	:

Provider Business Practice Location Address
First Line	:	1466 ROYCE ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5924
Country	:	US
Telephone Number	:	347-262-3865
Fax Number	:

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

Provider Enumeration Date	:	03/07/2025
Last Update Date	:	03/07/2025

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Directions to “ IVALYN MCWHORTER ” Practice Location

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