Individual provider Active NPI

Vella Tess

  • Registered Nurse
  • Lic, NY
National Provider Identifier
1558663153
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
627889-1 Issued in NY
Practice address
28-11 Queens Plaza N.
4TH FL.
Lic, NY 11101
Phone
(718) 391-8116
NPI assigned
Dec 2, 2010
Last updated
Dec 2, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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 627889-1 NY Primary

Addresses

Primary practice location

28-11 Queens Plaza N.
4TH FL.
Lic, NY 11101

Mailing address

1159 Brighton Beach Ave
Apt 1a
Brooklyn, NY 11235
Phone (718) 769-8679

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
627889-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1558663153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 BRIGHTON BEACH AVE",
            "address_2": "APT 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11235",
            "telephone_number": "718-769-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28-11 QUEENS PLAZA N.",
            "address_2": "4TH FL.",
            "city": "LIC",
            "state": "NY",
            "postal_code": "11101",
            "telephone_number": "718-391-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESS",
        "first_name": "VELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "627889-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lic, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.