Elizabeth Mae Dillenbeck

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

487382 Issued in NY

Practice address

1339 Baum Rd
St Johnsville, NY 13452-4303

Phone

(518) 475-8974

NPI assigned

Jul 13, 2010

Last updated

Feb 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1407168990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1339 BAUM RD",
            "city": "ST JOHNSVILLE",
            "state": "NY",
            "postal_code": "134524303",
            "telephone_number": "518-475-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 BAUM RD",
            "city": "ST JOHNSVILLE",
            "state": "NY",
            "postal_code": "134524303",
            "telephone_number": "518-475-8974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLENBECK",
        "first_name": "ELIZABETH",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "487382",
            "primary": true
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "487382",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Cool
• Stacey A Cool
• Craig L Murcray
• Melanie Ann Davies, M.S., SLP-LIC.
• Heather Marie Desmond, PTA
• Lesha Dolan, PTA
• Rachael Ann Faulkner, DPT
• Jennifer Lynn Flanders, RN
• Mark Joseph Villanueva Gamboa
• Fay Guilleguitan

• Registered Nurse in St Johnsville, NY
• Providers in St Johnsville, NY by specialty
• Registered Nurse in New York

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