Individual provider Active NPI

Marianne T Meenan, REGISTERED NURSE

  • Registered Nurse
  • Mahopac, NY
National Provider Identifier
1881979243
Registry record updated May 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
317643 Issued in NY
Practice address
55 Fulmar Rd
Mahopac, NY 10541-4512
Phone
(845) 628-3457
Fax
(845) 628-3445
NPI assigned
Oct 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 317643 NY Primary

Addresses

Primary practice location

55 Fulmar Rd
Mahopac, NY 10541-4512

Mailing address

55 Fulmar Rd
Mahopac, NY 10541-4512
Phone (845) 628-3457

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
317643NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495497600000",
    "number": "1881979243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FULMAR RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105414512",
            "telephone_number": "845-628-3457",
            "fax_number": "845-628-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FULMAR RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105414512",
            "telephone_number": "845-628-3457",
            "fax_number": "845-628-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEENAN",
        "first_name": "MARIANNE",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2017-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "317643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahopac, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; 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.