MEDICARE: NANYELY MERINO

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1871993071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANYELY MERINO

Provider Business Mailing Address
First Line	:	6017 HUDSON AVE APT 32
Second Line	:
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-2890
Country	:	US
Telephone Number	:	212-732-5427
Fax Number	:	212-964-9607

Provider Business Practice Location Address
First Line	:	6017 HUDSON AVE
Second Line	:	APT. 32
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-2865
Country	:	US
Telephone Number	:	212-732-5427
Fax Number	:	212-964-9607

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

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	08/26/2014

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