Mary Lou Dalton-Zacharewski, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

302209-1 Issued in NY

Practice address

9 Wedgeworth PT
West Monroe, NY 13167-3242

Phone

(315) 263-2397

NPI assigned

Sep 19, 2010

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

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": "1284854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1134437619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WEDGEWORTH PT",
            "city": "WEST MONROE",
            "state": "NY",
            "postal_code": "131673242",
            "telephone_number": "315-263-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 WEDGEWORTH PT",
            "city": "WEST MONROE",
            "state": "NY",
            "postal_code": "131673242",
            "telephone_number": "315-263-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON-ZACHAREWSKI",
        "first_name": "MARY",
        "middle_name": "LOU",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-19",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "302209-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bethany Lyn Penrod

• Licensed Practical Nurse in West Monroe, NY
• Providers in West Monroe, 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 Jan 21, 2011; 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.