Cardene Crestel Wallace

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

169322-1 Issued in NY

Practice address

106 Winthrop Ave
New Rochelle, NY 10801-3313

Phone

(914) 433-5331

NPI assigned

Feb 27, 2008

Last updated

Mar 21, 2008By the provider in NPPES

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Private Duty Nurse

  • Physical Disabilities Residential Treatment Facility
  • New Rochelle, NY
  • NPI 1386812485
  Authorized official Same address or phone

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1174792782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 WINTHROP AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108013313",
            "telephone_number": "914-433-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 WINTHROP AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108013313",
            "telephone_number": "914-433-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CARDENE",
        "middle_name": "CRESTEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "169322-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diadji Wague, RN, IBCLC
• Walk in Family Dental Off.
• Walk in Family Dental Office
• Pilar T. Walker, LMHC
• Sharon Walker, LCSW
• Susan Wallis, M.D.
• I-Chuan Wang
• Kaifeng Wang
• Dawn Jennifer Ward
• Leslie Nicole Ward

• Licensed Practical Nurse in New Rochelle, NY
• Providers in New Rochelle, 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 21, 2008; 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.