Individual provider Active NPI

Victoria Wiggan, LPN

  • Pediatric Skilled Nursing Facility
  • Glen Cove, NY
National Provider Identifier
1801018213
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X
License
02380225 Issued in NY
Practice address
56 Viola Dr
Glen Cove, NY 11542-3326
Phone
(631) 478-1327
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Skilled Nursing Facility 3140N1450X 02380225 NY Primary

Addresses

Primary practice location

56 Viola Dr
Glen Cove, NY 11542-3326

Mailing address

11542 219TH St
Cambria Heights, NY 11411-1162
Phone (718) 949-0108

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
02380225NYMDPediatric Skilled Nursing Facility

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801018213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11542 219TH ST",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111162",
            "telephone_number": "718-949-0108",
            "fax_number": "718-949-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 VIOLA DR",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115423326",
            "telephone_number": "631-478-1327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGAN",
        "first_name": "VICTORIA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "NY",
            "license": "02380225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.