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NPI Code Detail

MEDICARE: MRS. RUTH SMITH REGISTERED NURSE

MEDICARE:  MRS. RUTH  SMITH  REGISTERED NURSE
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
1163W00000XRegistered Nurse675264-1NY

General Provider Information

NPI Number : 1992164511
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RUTH SMITH REGISTERED NURSE
Provider Business Mailing Address
First Line : 109 SAINT NICHOLAS AVE
Second Line : 1L
City : BROOKLYN
State : NY
Zip : 11237-3447
Country : US
Telephone Number : 646-415-4707
Fax Number :
Provider Business Practice Location Address
First Line : 109 SAINT NICHOLAS AVE
Second Line : 1L
City : BROOKLYN
State : NY
Zip : 11237-3447
Country : US
Telephone Number : 646-415-4707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2016
Last Update Date : 02/11/2016

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Directions to “ MRS. RUTH SMITH REGISTERED NURSE” Practice Location

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