Individual provider Active NPI

Lorraine Wisnieski, R.N.

  • Methadone Clinic
  • Hauppauge, NY
National Provider Identifier
1285020396
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
297848-1 Issued in NY
Practice address
200 Wireless Blvd
Hauppauge, NY 11788-3974
Phone
(631) 853-7373
NPI assigned
Apr 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X 297848-1 NY Primary

Addresses

Primary practice location

200 Wireless Blvd
Hauppauge, NY 11788-3974

Mailing address

2 Longwood Dr
Huntington Station, NY 11746-4716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
297848-1NYMDMethadone Clinic

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1285020396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LONGWOOD DR",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117464716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WIRELESS BLVD",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883974",
            "telephone_number": "631-853-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIESKI",
        "first_name": "LORRAINE",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NY",
            "license": "297848-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.