Individual provider Active NPI

Marie K Valcin

  • Registered Nurse
  • Freeport, NY
National Provider Identifier
1154569168
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
540201-1 Issued in NY
Practice address
45 Prince Ave
Freeport, NY 11520-1117
Phone
(516) 608-2927
NPI assigned
Jan 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 540201-1 NY Primary

Addresses

Primary practice location

45 Prince Ave
Freeport, NY 11520-1117

Mailing address

45 Prince Ave
Freeport, NY 11520-1117
Phone (516) 608-2927

Other identifiers 1

IdentifierTypeStateIssuer
540201-1OtherNYREGISTERED PROFESSIONAL NURSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
540201-1NYMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1154569168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 PRINCE AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201117",
            "telephone_number": "516-608-2927",
            "fax_number": "516-608-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 PRINCE AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201117",
            "telephone_number": "516-608-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALCIN",
        "first_name": "MARIE",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "540201-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED PROFESSIONAL NURSE",
            "identifier": "540201-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.