Georgette Prawl
Individual provider Active NPI Nurse's Aide · Bayshore, NY
NPI 1194184085 · NPPES record last updated Feb 19, 2016
Key facts
- NPI
- 1194184085
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- 343756041115E (NY)
- Practice address
- 54 1St Avenue
Bayshore, NY 11706 - Phone
- (631) 299-8908
- NPI assigned
- Feb 19, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 343756041115E | NY | MD | Nurse's Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 343756041115E | NY | Yes |
Addresses
Primary practice location
54 1St Avenue
Bayshore, NY 11706
Mailing address
54 1St Avenue
Bayshore, NY 11706
Phone (631) 299-8908
Other providers in Bayshore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.