Peggy Sue Tryonoviech, LPN

Individual provider Active NPI Licensed Practical Nurse · Dover Plains, NY

NPI 1013334549 · NPPES record last updated Mar 21, 2014

Key facts

NPI
1013334549
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
269761 (NY)
Practice address
40 Glen Ave
Dover Plains, NY 12522-6029
Phone
(845) 702-7555
NPI assigned
Mar 21, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
29956CTMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 29956 CT
Licensed Practical Nurse 164W00000X 269761 NY Yes

Addresses

Primary practice location

40 Glen Ave
Dover Plains, NY 12522-6029

Mailing address

40 Glen Ave
Dover Plains, NY 12522-6029
Phone (845) 702-7555

Other providers in Dover Plains, NY

All providers in Dover Plains, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.