Individual ProviderFasilat IbrahimRegistered NurseNursing Service ProvidersPractice Address1117 Adee St, Bronx, NY 10469(917) 251-6275PECOS EnrollmentBased on the most recent information from CMS, provider Fasilat Ibrahim 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 7 days ago.Profile DetailsProvider ID1215495221Provider TypeIndividualFull NameIbrahim, FasilatGenderFemaleSole ProprietorNoEnumeration Date3/8/2019Last Updated3/8/2019Contact InformationPractice LocationPractice Address1117 Adee St, Bronx, NY 10469Phone(917) 251-6275FaxUnlisted FaxMailing LocationMailing Address1117 Adee St, Bronx, NY 10469PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense763423New York