Provider Demographics
NPI:1124451786
Name:MEDICI, NORINA GLENDA (RN)
Entity type:Individual
Prefix:MRS
First Name:NORINA
Middle Name:GLENDA
Last Name:MEDICI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13D MARPLE LN
Mailing Address - Street 2:
Mailing Address - City:HILTON
Mailing Address - State:NY
Mailing Address - Zip Code:14468-1496
Mailing Address - Country:US
Mailing Address - Phone:585-503-7862
Mailing Address - Fax:585-300-6718
Practice Address - Street 1:13D MARPLE LN
Practice Address - Street 2:
Practice Address - City:HILTON
Practice Address - State:NY
Practice Address - Zip Code:14468-1496
Practice Address - Country:US
Practice Address - Phone:585-503-7862
Practice Address - Fax:585-300-6718
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-18
Last Update Date:2013-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA566380163W00000X
NY668143-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse