Janine Nilsson

Individual provider Active NPI Home Health Registered Nurse · East Moriches, NY

NPI 1356759062 · NPPES record last updated Jul 25, 2014

Key facts

NPI
1356759062
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
342868-1 (NY)
Practice address
35 Memorial Blvd
East Moriches, NY 11940-1438
Phone
(631) 878-3605
NPI assigned
Jul 25, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
342868-1NYMDHome Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 342868-1 NY Yes

Addresses

Primary practice location

35 Memorial Blvd
East Moriches, NY 11940-1438

Mailing address

35 Memorial Blvd
East Moriches, NY 11940-1438
Phone (631) 878-3605

Other identifiers

IdentifierTypeStateIssuer
J9NURSEMedicaidNY

Other providers in East Moriches, NY

All providers in East Moriches, NY · Home Health Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.