Individual provider Active NPI

Myla Valencia, LPN

  • Licensed Practical Nurse
  • Long Island City, NY
National Provider Identifier
1366155178
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
283061-01 Issued in NY
Practice address
3711 Queens Blvd
Long Island City, NY 11101-1725
Phone
(718) 606-3863
NPI assigned
Dec 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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 283061-01 NY Primary

Addresses

Primary practice location

3711 Queens Blvd
Long Island City, NY 11101-1725

Mailing address

21215 43Rd Ave Apt 1a
Bayside, NY 11361-2835

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
283061-01NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1366155178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21215 43RD AVE APT 1A",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 QUEENS BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111011725",
            "telephone_number": "718-606-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "MYLA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "283061-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.