Jennifer Malycky, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

312088 Issued in NY

Practice address

39 Fallen Leaf Rd
Holbrook, NY 11741-2803

Phone

(631) 339-1914

NPI assigned

Mar 22, 2013

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": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1134461635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 FALLEN LEAF RD",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117412803",
            "telephone_number": "631-339-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 FALLEN LEAF RD",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117412803",
            "telephone_number": "631-339-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALYCKY",
        "first_name": "JENNIFER",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-22",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "312088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Donna L Maloupis, M.A., CCC/SLP
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• Carol Elaine Mandarino, LCSW CASAC
• Sara Alyssa Manetta
• Sarah Katherine Manger, LPN
• Loan Sam Mao-Patel, D.D.S

• Licensed Practical Nurse in Holbrook, NY
• Providers in Holbrook, 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 Mar 22, 2013; 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.