Individual ProviderStorm PortnerStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1 Gustave L. Levy Place, Department Of Psychiatry, New York, NY 10029(212) 659-8734PECOS EnrollmentBased on the most recent information from CMS, provider Storm Portner is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1245867340Provider TypeIndividualFull NamePortner, StormTitleMr.GenderMaleSole ProprietorNoEnumeration Date3/26/2020Last Updated3/26/2020Contact InformationPractice LocationPractice Address1 Gustave L. Levy Place, Department Of Psychiatry, New York, NY 10029Phone(212) 659-8734FaxUnlisted FaxMailing LocationMailing Address1 Gustave L. Levy Place, Department Of Psychiatry, Box 1230, New York, NY 10029Phone(212) 659-8734FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer