Active NPI
Lissett Spence
- Registered Nurse
- Far Rockaway, NY
National Provider Identifier
1164764775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 533584
- Practice address
- 2117 Nameoke Ave
Far Rockaway, NY 11691-3157 - Phone
- (718) 327-4405
- NPI assigned
- Mar 21, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 533584 | NY | Primary |
Addresses
Primary practice location
2117 Nameoke Ave
Far Rockaway, NY 11691-3157
Mailing address
2117 Nameoke Ave
Far Rockaway, NY 11691-3157
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
| License | State | Type | Specialty |
|---|---|---|---|
| 533584 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363824000000",
"number": "1164764775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2117 NAMEOKE AVE",
"city": "FAR ROCKAWAY",
"state": "NY",
"postal_code": "116913157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2117 NAMEOKE AVE",
"city": "FAR ROCKAWAY",
"state": "NY",
"postal_code": "116913157",
"telephone_number": "718-327-4405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENCE",
"first_name": "LISSETT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-21",
"last_updated": "2013-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "533584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Far Rockaway, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.