Mary B Wandle, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

290862-1 Issued in NY

Practice address

164 Prince Rd
Rocky Point, NY 11778-9763

Phone

(631) 849-3125

NPI assigned

Oct 8, 2009

Sex

Female

Sole proprietor

Yes

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": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254960000000",
    "number": "1770818767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 PRINCE RD",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117789763",
            "telephone_number": "631-849-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 PRINCE RD",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117789763",
            "telephone_number": "631-849-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANDLE",
        "first_name": "MARY",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-08",
        "last_updated": "2009-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "290862-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salvatore Rocco Vetro, RPH
• Trudy Vosper, RN
• Waldbaum Inc
• Walgreen Co
• Kaitlyn Walsh
• Stephanie Sue Wanlass, AGNP-C
• Margaret Ward, CASAC
• Nicole Danayja Washington
• Martine C Washingtonluykx
• Patrick Watters

• Licensed Practical Nurse in Rocky Point, NY
• Providers in Rocky Point, 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 Oct 8, 2009; 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.