Virginia Krawczuk

Individual provider Active NPI Licensed Practical Nurse · Pawling, NY

NPI 1780130302 · NPPES record last updated Sep 1, 2016

Key facts

NPI
1780130302
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
10132668 (NY)
Practice address
100 W Main Street
Pawling, NY 12564
Phone
(914) 282-0698
NPI assigned
Sep 1, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10132668NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 10132668 NY Yes

Addresses

Primary practice location

100 W Main Street
Pawling, NY 12564

Mailing address

100 W Main St
Pawling, NY 12564-1334
Phone (914) 282-0698

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 1, 2016.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1780130302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W MAIN ST",
            "city": "PAWLING",
            "state": "NY",
            "postal_code": "125641334",
            "telephone_number": "914-282-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W MAIN STREET",
            "city": "PAWLING",
            "state": "NY",
            "postal_code": "12564",
            "telephone_number": "914-282-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAWCZUK",
        "first_name": "VIRGINIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "10132668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawling, NY

All providers in Pawling, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.