Fairy Licemothers, LLC

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

FAIRY LICEMOTHERS, LLC

Practice address

2463 Long Beach Rd
Oceanside, NY 11572-1362

Phone

(866) 561-0492

NPI assigned

Jul 29, 2017

Organization subpart

No

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

Authorized official

Name

Carol Michelle Gilbert

Title

President

Phone

(516) 313-8095

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1501286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1235653437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2463 LONG BEACH RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721362",
            "telephone_number": "866-561-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2463 LONG BEACH RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721362",
            "telephone_number": "866-561-0492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1755 Deer Park Ave",
            "address_purpose": "LOCATION",
            "city": "Deer Park",
            "state": "NY",
            "postal_code": "117295207",
            "country_code": "US",
            "telephone_number": "866-561-0492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6507 Jester Blvd Ste 505A",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787508354",
            "country_code": "US",
            "telephone_number": "866-561-0492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "679 Glen Cove Ave",
            "address_purpose": "LOCATION",
            "city": "Glen Head",
            "state": "NY",
            "postal_code": "115451602",
            "country_code": "US",
            "telephone_number": "866-561-0492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAIRY LICEMOTHERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-29",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-313-8095"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health or Welfare Agency in Oceanside, NY
• Providers in Oceanside, NY by specialty
• Public Health or Welfare Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.