Jon Kristian Raymundo

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

314915-1 Issued in NY

Practice address

1350 Brooklyn Blvd
Bay Shore, NY 11706-4009

Phone

(631) 969-6517

NPI assigned

Jul 15, 2019

Sex

Male

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1831741305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 BROOKLYN BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BROOKLYN BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064009",
            "telephone_number": "631-969-6517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMUNDO",
        "first_name": "JON KRISTIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "314915-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Rapp
• Lewis B Rappaport, M.D.
• Carmen Rauch
• Dipti Ravindranath, MD
• Ray a Haag,MD PC
• Hassan Aftab Raza, MD
• Syed Samar Raza, M.D.
• Joann Read, MS CCC-SLP
• Recovery Consultant Services
• Reddy for Balance Acupuncture PLLC

• Licensed Practical Nurse in Bay Shore, NY
• Providers in Bay Shore, 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 Jul 15, 2019; 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.