Individual provider Active NPI

Nicole Ashley Lennon

  • Specialist
  • Plainview, NY
National Provider Identifier
1932600244
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
255 Executive Dr Ste Ll105
Plainview, NY 11803
Phone
(516) 576-0962
NPI assigned
Feb 22, 2018
Last updated
Aug 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

255 Executive Dr Ste Ll105
Plainview, NY 11803

Mailing address

35 Cavalier LN
Holtsville, NY 11742-1602

Other practice location 1

35 Cavalier Ln
Holtsville, NY 11742-1602
Phone (631) 965-0172

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

NPI Registry JSON

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1932600244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CAVALIER LN",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117421602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 EXECUTIVE DR STE LL105",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "11803",
            "telephone_number": "516-576-0962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Cavalier Ln",
            "address_purpose": "LOCATION",
            "city": "Holtsville",
            "state": "NY",
            "postal_code": "117421602",
            "country_code": "US",
            "telephone_number": "631-965-0172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LENNON",
        "first_name": "NICOLE",
        "middle_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-22",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.