Tanya Pruden

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

331792 Issued in NY

Practice address

155 Belmont Blvd
Elmont, NY 11003-2202

Phone

(516) 424-1457

NPI assigned

Mar 2, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1275167025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 BELMONT BLVD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032202",
            "telephone_number": "516-424-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BELMONT BLVD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032202",
            "telephone_number": "516-424-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUDEN",
        "first_name": "TANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "331792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Email",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "155 Belmont Blvd",
            "city": "Elmont",
            "state": "NY",
            "country_code": "US",
            "postal_code": "110032202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Kerwayne H Probherbs, M.D.
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• Myriam Prudhomme
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• Nancy Pugo
• Crystal Janice Purcell, RN

• Licensed Practical Nurse in Elmont, NY
• Providers in Elmont, 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 Mar 2, 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.