Geraldine Desgraviers, R.N.

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

624105 Issued in NY

Practice address

89 S 25TH St
Wyandanch, NY 11798-2905

Phone

(631) 575-7260

NPI assigned

Sep 20, 2011

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1265715924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 W FARM DR",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474153",
            "telephone_number": "631-575-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 S 25TH ST",
            "city": "WYANDANCH",
            "state": "NY",
            "postal_code": "117982905",
            "telephone_number": "631-575-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESGRAVIERS",
        "first_name": "GERALDINE",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "624105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Registered Nurse in Wyandanch, NY
• Providers in Wyandanch, NY by specialty
• General Practice Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.