Jennine Perez-Hargrove, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

331367 Issued in NY

Practice address

4238 Merrick Rd
Massapequa, NY 11758-6016

Phone

(866) 794-1644

NPI assigned

Aug 6, 2019

Last updated

Aug 6, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1215582341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CARROL ST",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117011854",
            "telephone_number": "631-842-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4238 MERRICK RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586016",
            "telephone_number": "866-794-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-HARGROVE",
        "first_name": "JENNINE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "331367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Massapequa, NY
• Providers in Massapequa, 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 Aug 6, 2019; 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.