Individual provider Active NPI

Elizabeth Thek, LPN

  • Licensed Practical Nurse
  • South Ozone Park, NY
National Provider Identifier
1730638305
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
246564 Issued in NY
Practice address
12417 111TH Ave
South Ozone Park, NY 11420-1507
Phone
(917) 685-7183
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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 246564 NY Primary

Addresses

Primary practice location

12417 111TH Ave
South Ozone Park, NY 11420-1507

Mailing address

12417 111TH Ave
South Ozone Park, NY 11420-1507
Phone (917) 685-7183

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
246564NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1730638305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12417 111TH AVE",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114201507",
            "telephone_number": "917-685-7183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12417 111TH AVE",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114201507",
            "telephone_number": "917-685-7183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEK",
        "first_name": "ELIZABETH",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "246564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.