Grace Funmilayo Dada | Spring Valley, NY • PECOS Search

Grace Funmilayo Dada

Registered Nurse

Nursing Service Providers

16 Bonnie Court, Spring Valley, NY 10977-2222

PECOS Enrollment

Based on the most recent information from CMS, provider Grace Funmilayo Dada does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:54 AM.

Profile Details

Provider ID
1013283480
Provider Type
Individual
Full Name
Dada, Grace Funmilayo
Credential
REGISTERED NURSE

Gender
Female
Sole Proprietor
Yes
Enumeration Date
3/29/2012
Last Updated
3/29/2012

Contact Information

Practice Location

16 Bonnie Court, Spring Valley, NY 10977-2222

Unlisted Fax

Mailing Location

16 Bonnie Ct, Spring Valley, NY 10977-2222

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 163W00000X Primary	Description Registered Nurse Nursing Service Providers	License 490374 New York