Darlene Beaucicot

Individual provider Active NPI Licensed Practical Nurse · Deer Park, NY

NPI 1114557683 · NPPES record last updated Jan 23, 2020

Key facts

NPI
1114557683
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
336634-01 (NY)
Practice address
4 Mark LN
Deer Park, NY 11729-6411
Phone
(516) 451-1142
NPI assigned
Jan 23, 2020
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
336634-01NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 336634-01 NY Yes

Addresses

Primary practice location

4 Mark LN
Deer Park, NY 11729-6411

Mailing address

4 Mark LN
Deer Park, NY 11729-6411

Other providers in Deer Park, NY

All providers in Deer Park, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.