Individual provider Active NPI

Mildred Maurissa Chery-Quiles, LPN

  • Licensed Practical Nurse
  • South Ozone Park, NY
National Provider Identifier
1356634596
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
305625-1 Issued in NY
Practice address
13518 123Rd St
South Ozone Park, NY 11420-3725
Phone
(516) 236-5213
NPI assigned
May 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 305625-1 NY Primary

Addresses

Primary practice location

13518 123Rd St
South Ozone Park, NY 11420-3725

Mailing address

13518 123Rd St
South Ozone Park, NY 11420-3725
Phone (516) 236-5213

Other identifiers 1

IdentifierTypeStateIssuer
305625-1MedicaidNY

Other names 1

  • Mrs. Mildred Maurissa Chery-Quiles Professional name

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

State licenses

LicenseStateTypeSpecialty
305625-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1356634596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13518 123RD ST",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203725",
            "telephone_number": "516-236-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13518 123RD ST",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203725",
            "telephone_number": "516-236-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERY-QUILES",
        "first_name": "MILDRED",
        "middle_name": "MAURISSA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-20",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "305625-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305625-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILDRED",
            "last_name": "CHERY-QUILES",
            "middle_name": "MAURISSA",
            "prefix": "MRS.",
            "credential": "LPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in South Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.