LPN

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

3141511 Issued in NY

Legal business name

LPN

Practice address

15 Lacrosse Rd
Mastic Beach, NY 11951-4901

Phone

(631) 729-6844

NPI assigned

Sep 24, 2014

Organization subpart

No

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

Authorized official

Name

Heather Rosalia

Title

Licensed Practical Nurse

Phone

(631) 729-6844

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1255733978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LACROSSE RD",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119514901",
            "telephone_number": "631-729-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 LACROSSE RD",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119514901",
            "telephone_number": "631-729-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LPN",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "ROSALIA",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "LICENSED PRACTICAL NURSE",
        "authorized_official_telephone_number": "16317296844"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NY",
            "license": "3141511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Mastic Beach, NY
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• In Home Supportive Care Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.