Individual provider Active NPI

Suzette Dubuisson, LPN

  • Licensed Practical Nurse
  • Elmont, NY
National Provider Identifier
1366775710
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
244047 Issued in NY
Practice address
92 Hathaway Ave
Elmont, NY 11003-2025
Phone
(516) 328-1237
NPI assigned
Sep 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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 244047 NY Primary

Addresses

Primary practice location

92 Hathaway Ave
Elmont, NY 11003-2025

Mailing address

92 Hathaway Ave
Elmont, NY 11003-2025

Other identifiers 1

IdentifierTypeStateIssuer
244047OtherNYOFFICE OF PROFESSIONS - LPN LICENSE

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
244047NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1366775710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 HATHAWAY AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 HATHAWAY AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032025",
            "telephone_number": "516-328-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBUISSON",
        "first_name": "SUZETTE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "244047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OFFICE OF PROFESSIONS - LPN LICENSE",
            "identifier": "244047",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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.