Maximillien Prophile, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

328897 Issued in NY

Practice address

16937 144TH Rd
Jamaica, NY 11434-5929

Phone

(718) 978-7222

NPI assigned

Sep 21, 2017

Sex

Male

Sole proprietor

No

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": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1629587670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 E 83RD ST FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363541",
            "telephone_number": "347-455-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16937 144TH RD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114345929",
            "telephone_number": "718-978-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROPHILE",
        "first_name": "MAXIMILLIEN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-21",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "328897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Jamaica, NY
• Providers in Jamaica, 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 Sep 21, 2017; 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.