Individual ProviderDoreva R KinlawSpecialistOther Service ProvidersPractice Address598 Grand Concourse, 2nd Fl, Bronx, NY 10451-1706(347) 928-2175PECOS EnrollmentBased on the most recent information from CMS, provider Doreva R Kinlaw 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 today at 8:41 AM.Profile DetailsProvider ID1407546237Provider TypeIndividualFull NameKinlaw, Doreva RCredentialESTHETICIANGenderFemaleSole ProprietorYesEnumeration Date5/15/2023Last Updated9/11/2024Contact InformationPractice LocationPractice Address598 Grand Concourse, 2nd Fl, Bronx, NY 10451-1706Phone(347) 928-2175FaxUnlisted FaxMailing LocationMailing Address598 Grand Concourse, 2nd Fl, Bronx, NY 10451-1706Phone(347) 928-2175FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode174400000XPrimaryDescriptionSpecialistOther Service ProvidersLicenseAEE-23-00186New York