Individual provider Active NPI

Diane Mary Monahan, LPN BSN

  • Licensed Practical Nurse
  • Ferndale, NY
National Provider Identifier
1417965401
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
14890 Issued in NY
Practice address
39 Old Monticello Rd
Ferndale, NY 12734
Phone
(845) 292-6684
NPI assigned
Aug 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 14890 NY Primary

Addresses

Primary practice location

39 Old Monticello Rd
Ferndale, NY 12734

Mailing address

PO Box 323
3641 St RT 55
Kauneonga Lake, NY 12749
Phone (845) 583-6195

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
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
14890NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417965401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 323",
            "address_2": "3641 ST RT 55",
            "city": "KAUNEONGA LAKE",
            "state": "NY",
            "postal_code": "12749",
            "telephone_number": "845-583-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 OLD MONTICELLO RD",
            "city": "FERNDALE",
            "state": "NY",
            "postal_code": "12734",
            "telephone_number": "845-292-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONAHAN",
        "first_name": "DIANE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "LPN BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "14890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.