Individual provider Active NPI

Nanan Cisse

  • Registered Nurse
  • New York, NY
National Provider Identifier
1417544990
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
742537-01 Issued in NY
Practice address
1432 5TH Ave
New York, NY 10035-4521
Phone
(646) 289-7731
Fax
(646) 289-7791
NPI assigned
Dec 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 742537-01 NY Primary

Addresses

Primary practice location

1432 5TH Ave
New York, NY 10035-4521

Mailing address

2156 Hone Ave
Bronx, NY 10461-1250
Phone (212) 690-0528

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
742537-01NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1417544990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2156 HONE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611250",
            "telephone_number": "212-690-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100354521",
            "telephone_number": "646-289-7731",
            "fax_number": "646-289-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISSE",
        "first_name": "NANAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "742537-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.