Individual provider Active NPI

Annae Alise Amazan

  • Licensed Practical Nurse
  • New Rochelle, NY
National Provider Identifier
1407670102
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
350877 Issued in NY
Practice address
20 Sickles Ave
New Rochelle, NY 10801-4030
Phone
(914) 406-1929
NPI assigned
Nov 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 350877 NY Primary

Addresses

Primary practice location

20 Sickles Ave
New Rochelle, NY 10801-4030

Mailing address

20 Sickles Ave
New Rochelle, NY 10801-4030

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

State licenses

LicenseStateTypeSpecialty
350877NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1407670102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SICKLES AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108014030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SICKLES AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108014030",
            "telephone_number": "914-406-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAZAN",
        "first_name": "ANNAE",
        "middle_name": "ALISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "350877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.