Individual provider Active NPI

Asiaj C Tullon, LPN

  • Licensed Practical Nurse
  • Medford, NY
National Provider Identifier
1003486622
Registry record updated Jun 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
341460 Issued in NY
Practice address
2907 Sipp Ave
Medford, NY 11763-1984
Phone
(631) 428-0666
NPI assigned
Jun 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 341460 NY Primary

Addresses

Primary practice location

2907 Sipp Ave
Medford, NY 11763-1984

Mailing address

2907 Sipp Ave
Medford, NY 11763-1984
Phone (631) 428-0666

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

State licenses

LicenseStateTypeSpecialty
341460NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1624665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624665600000",
    "number": "1003486622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 SIPP AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631984",
            "telephone_number": "631-428-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 SIPP AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631984",
            "telephone_number": "631-428-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLON",
        "first_name": "ASIAJ",
        "middle_name": "C",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-26",
        "last_updated": "2021-06-26",
        "certification_date": "2021-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "341460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2021; 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.