Individual ProviderNicola GaynorRegistered NurseNursing Service ProvidersPractice Address2052 Tillotson Ave, Bronx, NY 10475-1560(646) 748-8703PECOS EnrollmentBased on the most recent information from CMS, provider Nicola Gaynor does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1205232725Provider TypeIndividualFull NameGaynor, NicolaGenderFemaleSole ProprietorYesEnumeration Date11/11/2014Last Updated11/11/2014Contact InformationPractice LocationPractice Address2052 Tillotson Ave, Bronx, NY 10475-1560Phone(646) 748-8703FaxUnlisted FaxMailing LocationMailing Address1143 E 221st St, Bronx, NY 10469-1505Phone(646) 748-8703FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense693764New YorkProvider IdentifiersIDDescriptionIssuerIDJPR28989F01DescriptionMedicaidIssuerUnlistedNew York