Individual provider Active NPI

Edward Sackie, LPN

  • Licensed Practical Nurse
  • Yonkers, NY
National Provider Identifier
1396016168
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
308135 Issued in NY
Practice address
34 Cypress St BSMT
Yonkers, NY 10704-2606
Phone
(646) 726-7263
NPI assigned
Jan 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 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 308135 NY Primary

Addresses

Primary practice location

34 Cypress St BSMT
Yonkers, NY 10704-2606

Mailing address

34 Cypress St BSMT
Yonkers, NY 10704-2606
Phone (646) 726-7263

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

NPI Registry JSON

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1396016168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 CYPRESS ST BSMT",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107042606",
            "telephone_number": "646-726-7263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 CYPRESS ST BSMT",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107042606",
            "telephone_number": "646-726-7263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKIE",
        "first_name": "EDWARD",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-25",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "308135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.