Individual provider Active NPI

Telitha Liss Abraham, R.N.

  • Registered Nurse
  • Goldens Bridge, NY
National Provider Identifier
1003255068
Registry record updated Jun 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
660952-1 Issued in NY
Practice address
16 Billingsley TRL
Goldens Bridge, NY 10526-1411
Phone
(914) 232-3920
Fax
(914) 232-3920
NPI assigned
Jun 22, 2013
Last updated
Jun 22, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 660952-1 NY Primary

Addresses

Primary practice location

16 Billingsley TRL
Goldens Bridge, NY 10526-1411

Mailing address

16 Billingsley TRL
Goldens Bridge, NY 10526-1411
Phone (914) 232-3920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
660952-1NYMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371859200000",
    "number": "1003255068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BILLINGSLEY TRL",
            "city": "GOLDENS BRIDGE",
            "state": "NY",
            "postal_code": "105261411",
            "telephone_number": "914-232-3920",
            "fax_number": "914-232-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BILLINGSLEY TRL",
            "city": "GOLDENS BRIDGE",
            "state": "NY",
            "postal_code": "105261411",
            "telephone_number": "914-232-3920",
            "fax_number": "914-232-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "TELITHA LISS",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-22",
        "last_updated": "2013-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "660952-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldens Bridge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.