Individual provider Active NPI

Ellen Mary McNulty, RN

  • School Registered Nurse
  • Rockaway Park, NY
National Provider Identifier
1245506088
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
368986-1 Issued in NY
Practice address
320 Beach 104TH St
Rockaway Park, NY 11694-2782
Phone
(718) 474-6918
Fax
(718) 945-8958
NPI assigned
Mar 27, 2012
Last updated
Mar 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 368986-1 NY Primary

Addresses

Primary practice location

320 Beach 104TH St
Rockaway Park, NY 11694-2782

Mailing address

320 Beach 104TH St
Rockaway Park, NY 11694-2782
Phone (718) 474-6918

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
368986-1NYMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1245506088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 BEACH 104TH ST",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942782",
            "telephone_number": "718-474-6918",
            "fax_number": "718-945-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 BEACH 104TH ST",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942782",
            "telephone_number": "718-474-6918",
            "fax_number": "718-945-8958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "ELLEN",
        "middle_name": "MARY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "368986-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockaway Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.