Michele L Eiswerth, REGISTERED NURSE

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

489298 Issued in NY

Practice address

706 Executive Blvd
Valley Cottage, NY 10989-2038

Phone

(390) 484-5362

NPI assigned

Sep 11, 2020

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

Other names 1

• Miss Michele L Stimeck Other name

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": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1255946703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 EXECUTIVE BLVD",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892038",
            "telephone_number": "845-362-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 EXECUTIVE BLVD",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892038",
            "telephone_number": "390-484-5362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISWERTH",
        "first_name": "MICHELE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "489298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "STIMECK",
            "middle_name": "L",
            "prefix": "MISS",
            "credential": "REGISTERED NURSE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Addiction (Substance Use Disorder) Registered Nurse in Valley Cottage, NY
• Providers in Valley Cottage, NY by specialty
• Addiction (Substance Use Disorder) Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.