MEDICARE: CHARLENE MARIE DIGIACOMO

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	163W00000X	Registered Nurse	363046-1	NY

General Provider Information

NPI Number	:	1942717889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLENE MARIE DIGIACOMO

Provider Business Mailing Address
First Line	:	4 VASCELLO RD
Second Line	:
City	:	NEW WINDSOR
State	:	NY
Zip	:	12553-5947
Country	:	US
Telephone Number	:	845-781-8989
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 VASCELLO RD
Second Line	:
City	:	NEW WINDSOR
State	:	NY
Zip	:	12553-5947
Country	:	US
Telephone Number	:	845-781-8989
Fax Number	:

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

Provider Enumeration Date	:	12/31/2017
Last Update Date	:	12/31/2017

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Directions to “ CHARLENE MARIE DIGIACOMO ” Practice Location

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