Active NPI
Clarice Harris
- Licensed Practical Nurse
- Staten Island, NY
National Provider Identifier
1043706385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 0200204
- Practice address
- 190 Egbert Ave
Staten Island, NY 10310-2622 - Phone
- (212) 470-3160
- NPI assigned
- Jul 10, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 0200204 | NY | Primary |
Addresses
Primary practice location
190 Egbert Ave
Staten Island, NY 10310-2622
Mailing address
190 Egbert Ave
Staten Island, NY 10310-2622
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0200204 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531180800000",
"number": "1043706385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 EGBERT AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103102622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 EGBERT AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103102622",
"telephone_number": "212-470-3160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "CLARICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-10",
"last_updated": "2018-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "0200204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.