Individual provider Active NPI

Jenny Verghese

  • Licensed Practical Nurse
  • East Elmhurst, NY
National Provider Identifier
1881007789
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
316595 Issued in NY
Practice address
8803 30TH Ave
East Elmhurst, NY 11369-1432
Phone
(646) 284-3982
NPI assigned
Jun 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 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 316595 NY Primary

Addresses

Primary practice location

8803 30TH Ave
East Elmhurst, NY 11369-1432

Mailing address

88-03 30TH Avenue
East Elmhurst, NY 11369
Phone (646) 284-3982

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
316595NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1881007789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88-03 30TH AVENUE",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "11369",
            "telephone_number": "646-284-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8803 30TH AVE",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "113691432",
            "telephone_number": "646-284-3982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGHESE",
        "first_name": "JENNY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "316595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.