Individual provider Active NPI

Maryse Sannon

  • Registered Nurse
  • Valley Cottage, NY
National Provider Identifier
1639484447
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
561040 Issued in NY
Practice address
821 Sherry Dr
Valley Cottage, NY 10989-2203
Phone
(845) 267-8355
NPI assigned
Aug 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 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 561040 NY Primary

Addresses

Primary practice location

821 Sherry Dr
Valley Cottage, NY 10989-2203

Mailing address

821 Sherry Dr
Valley Cottage, NY 10989-2203
Phone (845) 267-8355

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
561040NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1639484447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 SHERRY DR",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892203",
            "telephone_number": "845-267-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 SHERRY DR",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892203",
            "telephone_number": "845-267-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANNON",
        "first_name": "MARYSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "561040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Cottage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.