Sandra M Tejkl, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

239597-1 Issued in NY

Practice address

218 Riverside Ave
Theresa, NY 13691-0285

Phone

(315) 408-8672

NPI assigned

Feb 20, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1043355183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 RIVERSIDE AVE",
            "city": "THERESA",
            "state": "NY",
            "postal_code": "13691",
            "telephone_number": "315-408-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 RIVERSIDE AVE",
            "city": "THERESA",
            "state": "NY",
            "postal_code": "136910285",
            "telephone_number": "315-408-8672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJKL",
        "first_name": "SANDRA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "239597-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02175226",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pablo Otero, RN
• Amy Lynn Petrie, LPN
• Todd C Reed, LPN
• Chanelle Juanita Savage
• Amanda Leigh Smith, PA-C
• Kaleanna A Weatherup-Otero, LPN

• Licensed Practical Nurse in Theresa, NY
• Providers in Theresa, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.