1811100415 NPI number — MRS. TERRI ANNE FEDERIGHI LPN

Table of content: MRS. TERRI ANNE FEDERIGHI LPN (NPI 1811100415)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811100415 NPI number — MRS. TERRI ANNE FEDERIGHI LPN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FEDERIGHI
Provider First Name:
TERRI
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811100415
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
134 SO VACATION DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAPPINGERS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12590
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-226-1729
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34 STILLWATER RD
Provider Second Line Business Practice Location Address:
MICHEAL DALY
Provider Business Practice Location Address City Name:
MAHOPAC
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-628-0373
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/08/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 164W00000X , with the licence number:  LPN 243609 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)