Akissi B Edjemin, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

305399-1 Issued in NY

Practice address

53 Clinton St
Staten Island, NY 10304-2245

Phone

(718) 720-7034

Fax

(718) 720-7034

NPI assigned

Apr 25, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1497046494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVE,",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053409",
            "telephone_number": "718-668-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 CLINTON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042245",
            "telephone_number": "718-720-7034",
            "fax_number": "718-720-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDJEMIN",
        "first_name": "AKISSI",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-25",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "305399-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denis Ali Eder, LMHC
• Nicole B Edgar
• Megan Nicole Edgerly
• Benjeil Zurishaddai Edghill, MD
• Mary Ann Soto Edghill, M.D.
• Nestor Ann Edmondson
• Sandra Marie Edris, RN
• Lauren Susan Edson Fisher, LCSW-R
• Edward J Ferdinando
• Allison Edwards, L.M.S.W.

• Licensed Practical Nurse in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.