Dedra D Joseph, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

280219-1 Issued in NY

Practice address

50 W Hawthorne Ave FL 2
Valley Stream, NY 11580-6223

Phone

(516) 204-1320

NPI assigned

Apr 28, 2021

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1255914263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 LINCOLN ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032322",
            "telephone_number": "516-412-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W HAWTHORNE AVE FL 2",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115806223",
            "telephone_number": "516-204-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "DEDRA",
        "middle_name": "D",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "280219-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jos-El Care Agency, Inc
• Jos-El Care Inc.
• Tokunbo Jimmy Jose
• Neena Josen, LMHC
• Claudy Joseph
• Gesner Joseph
• Guylene Joseph, LPN
• Leslie Joseph, DDS
• Lizette Joseph
• Myrtelle Joseph, RN

• Licensed Practical Nurse in Valley Stream, NY
• Providers in Valley Stream, 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 Apr 28, 2021; 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.