Jennifer Diaz, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

303305-1 Issued in NY

Practice address

393 Evergreen Ave
Central Islip, NY 11722-1906

Phone

(631) 355-1960

NPI assigned

Oct 30, 2010

Last updated

Oct 30, 2010By the provider in NPPES

Sex

Female

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": "1288396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288396800000",
    "number": "1922308428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 EVERGREEN AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117221906",
            "telephone_number": "631-355-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 EVERGREEN AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117221906",
            "telephone_number": "631-355-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JENNIFER",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-30",
        "last_updated": "2010-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "303305-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Central Islip, NY
• Providers in Central Islip, 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 Oct 30, 2010; 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.