Active NPI
Lisa Lynn Egnaczyk, RN
- Registered Nurse
- Old Forge, NY
National Provider Identifier
1447420195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 593804-1
- Practice address
- 166 Garmon Ave
Old Forge, NY 13420-0295 - Phone
- (315) 369-5007
- NPI assigned
- Mar 10, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 593804-1 | NY | Primary |
Addresses
Primary practice location
166 Garmon Ave
Old Forge, NY 13420-0295
Mailing address
166 Garmon Ave
PO Box 295
Old Forge, NY 13420-0295
Phone (315) 369-5007
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 593804-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205193600000",
"number": "1447420195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "166 GARMON AVE",
"address_2": "PO BOX 295",
"city": "OLD FORGE",
"state": "NY",
"postal_code": "134200295",
"telephone_number": "315-369-5007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "166 GARMON AVE",
"city": "OLD FORGE",
"state": "NY",
"postal_code": "134200295",
"telephone_number": "315-369-5007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGNACZYK",
"first_name": "LISA",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-10",
"last_updated": "2008-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "593804-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Old Forge, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.