Individual ProviderMyredson Mateo CabatotanRegistered NurseNursing Service ProvidersPractice Address8907 220th St, Queens Village, NY 11427-2505(718) 864-9823PECOS EnrollmentBased on the most recent information from CMS, provider Myredson Mateo Cabatotan 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 3 days ago.Profile DetailsProvider ID1548533466Provider TypeIndividualFull NameCabatotan, Myredson MateoCredentialRNGenderMaleSole ProprietorYesEnumeration Date2/23/2012Last Updated2/23/2012Contact InformationPractice LocationPractice Address8907 220th St, Queens Village, NY 11427-2505Phone(718) 864-9823FaxUnlisted FaxMailing LocationMailing Address8907 220th St, Queens Village, NY 11427-2505Phone(718) 864-9823FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense649660New York