Individual ProviderKoulako CamaraNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address10 Woods Rd, Valhalla, NY 10595-1529(914) 231-1085(845) 803-3500PECOS EnrollmentBased on the most recent information from CMS, provider Koulako Camara 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 3 days ago.Profile DetailsProvider ID1881202612Provider TypeIndividualFull NameCamara, KoulakoCredentialNPGenderFemaleSole ProprietorYesEnumeration Date7/17/2020Last Updated8/31/2021Contact InformationPractice LocationPractice Address10 Woods Rd, Valhalla, NY 10595-1529Phone(914) 231-1085FaxUnlisted FaxMailing LocationMailing Address15 Sherwood Dr, Poughkeepsie, NY 12603-6007Phone(845) 803-3500FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense345691New YorkCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense345691New York