Mary Patricia Odoherty, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

239868-1 Issued in NY

Practice address

13665 68TH Dr
Kew Gardens Hills, NY 11367-1619

Phone

(718) 897-1581

NPI assigned

Jul 14, 2010

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

State licenses

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1356654792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13665 68TH DRIVE",
            "city": "KEW GARDENS HILLS",
            "state": "NY",
            "postal_code": "11367",
            "telephone_number": "718-897-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13665 68TH DR",
            "city": "KEW GARDENS HILLS",
            "state": "NY",
            "postal_code": "113671619",
            "telephone_number": "718-897-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOHERTY",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-14",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "239868-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria K Mirosh
• Karen Jean Mulligan, PT
• Aliza Nashofer
• Tova Gittel Neuberger
• Nicole Nicotra
• Chana R Opoczynski
• Maria Angelica Ortiz Bautista
• Rosa M Pardo, LMSW
• Chaniqua Cassandra Phillips, MSED
• Carol Ann Potter, M.A., C.C.C./SLP

• Licensed Practical Nurse in Kew Gardens Hills, NY
• Providers in Kew Gardens Hills, 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 Jul 14, 2010; 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.