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NPI Code Detail

MEDICARE: ADRIANNE KOELB

MEDICARE:   ADRIANNE  KOELB
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1982018511
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIANNE KOELB
Provider Business Mailing Address
First Line : 132 WHEELER AVE APT A
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-4018
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 132 WHEELER AVE APT A
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-4018
Country : US
Telephone Number : 718-288-9056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2014
Last Update Date : 06/11/2014

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Directions to “ ADRIANNE KOELB ” Practice Location

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