Private Duty Nurse

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

169322-1 Issued in NY

Legal business name

PRIVATE DUTY NURSE

Practice address

106 Winthrop Ave
2ND Floor
New Rochelle, NY 10801-3313

Phone

(914) 433-5331

NPI assigned

Feb 12, 2008

Last updated

Feb 12, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Cardene Wallace, LPNNPI 1174792782

Title

LPN

Phone

(914) 433-5331

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cardene Crestel Wallace

  • Licensed Practical Nurse
  • New Rochelle, NY
  • NPI 1174792782
  Authorized official Same address or phone

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1386812485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 WINTHROP AVE",
            "address_2": "2ND FLOOR",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "10801",
            "telephone_number": "914-433-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 WINTHROP AVE",
            "address_2": "2ND FLOOR",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108013313",
            "telephone_number": "914-433-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DUTY NURSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "CARDENE",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "914-433-5331",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NY",
            "license": "169322-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marianne T. Prior-Boyer, FNP
• Eugene M Prisco, DDS
• Kristin Pritchard
• Nancy Pritz, R.N.
• Private Doctor's Office
• Private Medical Group of New Rochelle
• Professional Consultation Services
• Professional Consultation Services for Psychology,Speech Therapy, Occu
• Professional Occupational & Physical Therapy, PLLC
• Professional Occupational & Physical Therapy, PLLC

• Physical Disabilities Residential Treatment Facility in New Rochelle, NY
• Providers in New Rochelle, NY by specialty
• Physical Disabilities Residential Treatment Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.