MEDICARE: JAMILA PERKINS

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	164W00000X	Licensed Practical Nurse	302483-1	NY

General Provider Information

NPI Number	:	1891079083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMILA PERKINS

Provider Business Mailing Address
First Line	:	275 CLINTON AVE
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12210-2448
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 CLINTON AVE
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12210-2448
Country	:	US
Telephone Number	:	518-253-6732
Fax Number	:

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

Provider Enumeration Date	:	10/05/2011
Last Update Date	:	10/05/2011

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Directions to “ JAMILA PERKINS ” Practice Location

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