Active NPI
Ellen Sarmiento Bersabal, RN
- Registered Nurse
- Woodside, NY
National Provider Identifier
1356764641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 628491
- Practice address
- 3975 56TH St
Apt. 1E
Woodside, NY 11377-3391 - Phone
- (347) 761-4634
- NPI assigned
- Jan 23, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 628491 | NY | Primary |
Addresses
Primary practice location
3975 56TH St
Apt. 1E
Woodside, NY 11377-3391
Mailing address
3975 56TH St
Apt. 1E
Woodside, NY 11377-3391
Phone (347) 761-4634
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
| License | State | Type | Specialty |
|---|---|---|---|
| 628491 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390435200000",
"number": "1356764641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3975 56TH ST",
"address_2": "APT. 1E",
"city": "WOODSIDE",
"state": "NY",
"postal_code": "113773391",
"telephone_number": "347-761-4634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3975 56TH ST",
"address_2": "APT. 1E",
"city": "WOODSIDE",
"state": "NY",
"postal_code": "113773391",
"telephone_number": "347-761-4634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERSABAL",
"first_name": "ELLEN",
"middle_name": "SARMIENTO",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-23",
"last_updated": "2014-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "628491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.