Patricia Ann Pendergast, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

283085-1 Issued in NY

Practice address

8 Pinecrest PL
Selden, NY 11784-3516

Phone

(631) 609-7270

NPI assigned

Jun 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1083106017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 PINECREST PL",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117843516",
            "telephone_number": "631-609-7270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 PINECREST PL",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117843516",
            "telephone_number": "631-609-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGAST",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "NY",
            "license": "283085-1",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "283085-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David B Park, DDS MD
• Ruhi Pattel, PH. D
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• Mary Ann Pelzer, RPAC
• Nicole Marie Pena, LPN
• Debra Penna
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• Coleen Perrone
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• Licensed Practical Nurse in Selden, NY
• Providers in Selden, 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 Jun 5, 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.

Verify at the official NPI Registry.