Individual provider Active NPI

Pearl Edith Graziano, LPN

  • Licensed Practical Nurse
  • Kingston, NY
National Provider Identifier
1689957102
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
257173-1 Issued in NY
Practice address
803 Grant Avenue
Kingston, NY 12449
Phone
(845) 331-5064
Fax
(845) 331-0492
NPI assigned
Sep 21, 2011
Last updated
Sep 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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 257173-1 NY Primary

Addresses

Primary practice location

803 Grant Avenue
Kingston, NY 12449

Mailing address

15 Joys LN
Kingston, NY 12401-3705
Phone (845) 331-5064

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
257173-1NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Litson Certified Care, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1689957102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 JOYS LN",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013705",
            "telephone_number": "845-331-5064",
            "fax_number": "845-331-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 GRANT AVENUE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "12449",
            "telephone_number": "845-331-5064",
            "fax_number": "845-331-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAZIANO",
        "first_name": "PEARL",
        "middle_name": "EDITH",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "257173-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.