MEDICARE: DR. CLAUDIA JANE NELSON M.D. M.P.H.

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	2084P0800X	Psychiatry Physician	228455-1	NY

General Provider Information

NPI Number	:	1932242930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLAUDIA JANE NELSON M.D. M.P.H.

Provider Business Mailing Address
First Line	:	2920 BROADWAY
Second Line	:	MAIL CODE 2606 ALFRED LERNER HALL
City	:	NEW YORK
State	:	NY
Zip	:	10027
Country	:	US
Telephone Number	:	212-854-2878
Fax Number	:	212-854-9473

Provider Business Practice Location Address
First Line	:	2920 BROADWAY
Second Line	:	MAIL CODE 2606 ALFRED LERNER HALL
City	:	NEW YORK
State	:	NY
Zip	:	10027-7004
Country	:	US
Telephone Number	:	212-854-2878
Fax Number	:	212-854-9473

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

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	07/08/2007

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