1871781856 NPI number — DIANNE MCNESHIE LPN

Table of content: DIANNE MCNESHIE LPN (NPI 1871781856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871781856 NPI number — DIANNE MCNESHIE LPN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCNESHIE
Provider First Name:
DIANNE
Provider Middle Name:
Provider Name Prefix Text:
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:
1871781856
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17020 130TH AVE
Provider Second Line Business Mailing Address:
SUITE 7E
Provider Business Mailing Address City Name:
JAMAICA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11434-3283
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-242-6683
Provider Business Mailing Address Fax Number:
646-242-6683

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17020 130TH AVE
Provider Second Line Business Practice Location Address:
SUITE 7E
Provider Business Practice Location Address City Name:
JAMAICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11434-3283
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-242-6683
Provider Business Practice Location Address Fax Number:
646-242-6683
Provider Enumeration Date:
10/04/2007

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:  242949 , 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)

  • Identifier: 242949 . This is a "NY LICENSE NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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