Individual ProviderIsrael CampoverdeLicensed Practical NurseNursing Service ProvidersPractice Address365 Broadway, Amityville, NY 11701-2716(631) 608-8523PECOS EnrollmentBased on the most recent information from CMS, provider Israel Campoverde 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 ID1346785797Provider TypeIndividualFull NameCampoverde, IsraelCredentialLPNGenderMaleSole ProprietorYesEnumeration Date12/21/2016Last Updated12/21/2016Contact InformationPractice LocationPractice Address365 Broadway, Amityville, NY 11701-2716Phone(631) 608-8523FaxUnlisted FaxMailing LocationMailing Address365 Broadway, Amityville, NY 11701-2716Phone(631) 608-8523FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense317617New York