MEDICARE: CAROLYN IOCOLANO FNP

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	363LF0000X	Family Nurse Practitioner	333397	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982779120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN IOCOLANO FNP

Provider Business Mailing Address
First Line	:	PO BOX 95000-2409
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19195-0001
Country	:	US
Telephone Number	:	212-308-1112
Fax Number	:

Provider Business Practice Location Address
First Line	:	780 8TH AVE
Second Line	:	SUITE 303
City	:	NEW YORK
State	:	NY
Zip	:	10036-7000
Country	:	US
Telephone Number	:	212-641-6500
Fax Number	:	212-641-4510

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

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	11/10/2014

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