Clara Velma Haylock

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

329438 Issued in NY

Practice address

4528 40TH Ave
2R
Sunnyside, NY 11104

Phone

(347) 417-1245

NPI assigned

Sep 20, 2017

Sex

Female

Sole proprietor

No

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": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376052555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4528 40TH ST",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111043942",
            "telephone_number": "347-417-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4528 40TH AVE",
            "address_2": "2R",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "11104",
            "telephone_number": "347-417-1245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4528 40TH AVE",
            "address_2": "2R",
            "address_purpose": "LOCATION",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "11104",
            "country_code": "US",
            "telephone_number": "347-417-1245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYLOCK",
        "first_name": "CLARA",
        "middle_name": "VELMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "329438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Sunnyside, NY
• Providers in Sunnyside, 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 21, 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.