Marquita Byrd

Individual provider Active NPI Licensed Practical Nurse · Stone Ridge, NY

NPI 1376424267 · NPPES record last updated Sep 9, 2025

Key facts

NPI
1376424267
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
332754 (NY)
Practice address
12 Gagnon Dr
Stone Ridge, NY 12484
Phone
(845) 486-2850
NPI assigned
Sep 9, 2025
Sex
Female
Sole proprietor
No

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
332754NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 332754 NY Yes

Addresses

Primary practice location

12 Gagnon Dr
Stone Ridge, NY 12484

Mailing address

43 Gage St
Kingston, NY 12401-3019

Other providers in Stone Ridge, NY

All providers in Stone Ridge, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.