Individual provider Active NPI

Diane Andrea Elvin

  • Licensed Practical Nurse
  • Hackensack, NJ
National Provider Identifier
1184858482
Registry record updated May 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
296741 Issued in NJ
Practice address
62 Euclid Ave
Hackensack, NJ 07601-4510
Phone
(201) 820-3001
NPI assigned
May 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 296741 NJ Primary

Addresses

Primary practice location

62 Euclid Ave
Hackensack, NJ 07601-4510

Mailing address

62 Euclid Ave
Hackensack, NJ 07601-4510
Phone (201) 820-3001

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
296741NJMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242259200000",
    "number": "1184858482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 EUCLID AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014510",
            "telephone_number": "201-820-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 EUCLID AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014510",
            "telephone_number": "201-820-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELVIN",
        "first_name": "DIANE",
        "middle_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-14",
        "last_updated": "2009-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NJ",
            "license": "296741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.