MEDICARE: JAMES C. PACE APRN, BC

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	363LA2200X	Adult Health Nurse Practitioner	APN5499	TN

General Provider Information

NPI Number	:	1922110055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES C. PACE APRN, BC

Provider Business Mailing Address
First Line	:	356 W 18TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-4401
Country	:	US
Telephone Number	:	212-992-7343
Fax Number	:	212-995-4359

Provider Business Practice Location Address
First Line	:	356 W 18TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-4401
Country	:	US
Telephone Number	:	212-992-7343
Fax Number	:	212-995-4359

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	03/07/2023

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