Individual provider Active NPI

Wishny Etienne Dormay, LPN

  • Licensed Practical Nurse
  • East Islip, NY
National Provider Identifier
1831515170
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
314869-1 Issued in NY
Practice address
53 Washington St
Unit #B
East Islip, NY 11730-1844
Phone
(917) 862-5215
Fax
(718) 347-4643
NPI assigned
Mar 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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 314869-1 NY Primary

Addresses

Primary practice location

53 Washington St
Unit #B
East Islip, NY 11730-1844

Mailing address

PO Box 20838
Floral Park, NY 11002-0838
Phone (917) 862-5215

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
314869-1NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Leroy Herbert, MD,PC Past Accepting new patients
Manhattan Nephrology and Critical Care PLLC Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1831515170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20838",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110020838",
            "telephone_number": "917-862-5215",
            "fax_number": "718-347-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 WASHINGTON ST",
            "address_2": "UNIT #B",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117301844",
            "telephone_number": "917-862-5215",
            "fax_number": "718-347-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMAY",
        "first_name": "WISHNY",
        "middle_name": "ETIENNE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-11",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "314869-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.