Lyneah Tart, LPN

Individual provider Active NPI Licensed Practical Nurse · E Kingston, NY

NPI 1073789566 · NPPES record last updated May 13, 2008

Key facts

NPI
1073789566
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
272607-1 (NY)
Practice address
147 John St Apt 1
E Kingston, NY 12401
Phone
(845) 706-2078
Fax
(845) 336-8848
NPI assigned
May 5, 2008
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
PN 5162685FLMDLicensed Practical Nurse
272607-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 272607-1 NY Yes
Licensed Practical Nurse 164W00000X PN 5162685 FL

Addresses

Primary practice location

147 John St Apt 1
E Kingston, NY 12401

Mailing address

147 John St Apt 1
E Kingston, NY 12401
Phone (845) 706-2078

Sources for this page

Verify at the official NPI Registry.