Individual provider Active NPI

Donna Marie Gresio, LPN

  • Licensed Practical Nurse
  • East Patchogue, NY
National Provider Identifier
1629549381
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
251563 Issued in NY
Practice address
353 Patchogue Yaphank Rd
East Patchogue, NY 11772-4826
Phone
(631) 205-4188
NPI assigned
Dec 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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 251563 NY Primary

Addresses

Primary practice location

353 Patchogue Yaphank Rd
East Patchogue, NY 11772-4826

Mailing address

353 Patchogue Yaphank Rd
East Patchogue, NY 11772-4826
Phone (631) 205-4188

Other names 1

  • Mrs. Donna Gresio Kershaw Professional name

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
251563NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1629549381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 PATCHOGUE YAPHANK RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724826",
            "telephone_number": "631-205-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 PATCHOGUE YAPHANK RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724826",
            "telephone_number": "631-205-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESIO",
        "first_name": "DONNA",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "251563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "KERSHAW",
            "middle_name": "GRESIO",
            "prefix": "MRS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in East Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.