Ivana Carmela St. John | Brooklyn, NY • PECOS Search

Ivana Carmela St. John

Specialist

Other Service Providers

7616 13th Ave, Brooklyn, NY 11228-2412

PECOS Enrollment

Based on the most recent information from CMS, provider Ivana Carmela St. John 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 2 days ago.

Profile Details

Provider ID
1164783395
Provider Type
Individual
Full Name
St. John, Ivana Carmela
Credential
MSED

Gender
Female
Sole Proprietor
Yes
Enumeration Date
6/5/2012
Last Updated
2/12/2018

Contact Information

Practice Location

7616 13th Ave, Brooklyn, NY 11228-2412

Unlisted Fax

Mailing Location

435 Bertram Ave, Staten Island, NY 10312-5832

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 174400000X Primary	Description Specialist Other Service Providers	License Unlisted Issuer