Joanne San Juan Fedelicio, MSN RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

558454 Issued in NY

Practice address

376 Woodward Ave
Apt 2L
Ridgewood, NY 11385-1357

Phone

(347) 689-4420

NPI assigned

Feb 17, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1932406444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 WOODWARD AVE",
            "address_2": "APT 2L",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113851357",
            "telephone_number": "347-689-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 WOODWARD AVE",
            "address_2": "APT 2L",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113851357",
            "telephone_number": "347-689-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDELICIO",
        "first_name": "JOANNE",
        "middle_name": "SAN JUAN",
        "name_prefix": "Mrs.",
        "credential": "MSN RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "558454",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NY",
            "license": "558454",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivian W Fan
• Gerges Fanous
• Maria Michelle Fareri, M.S., CCC-SLP
• Madison Rae Farr, PMHNP
• Farzin Farokhzadeh DDS PC
• Franklin Felipe Fernandez, D.D.S
• Maria Elena Fernandez, BSN, RN
• Noemi Ferres
• Viola Chiara Ferriolo
• Tanya Fiebert

• Registered Nurse in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.