Individual provider Active NPI

Maureen Ellen Clifford

  • Personal Emergency Response Attendant
  • Syracuse, NY
National Provider Identifier
1942482997
Registry record updated Dec 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Emergency Response AttendantTaxonomy code 146D00000X
Practice address
4552 Knolltop Ter
Syracuse, NY 13215-1566
Phone
(315) 412-4350
Fax
(315) 299-5074
NPI assigned
Dec 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Emergency Response Attendant 146D00000X NY Primary

Addresses

Primary practice location

4552 Knolltop Ter
Syracuse, NY 13215-1566

Mailing address

4552 Knolltop Ter
Syracuse, NY 13215-1566
Phone (315) 412-4350

Other identifiers 1

IdentifierTypeStateIssuer
02473792MedicaidNY

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
261206300NYMDPersonal Emergency Response Attendant

NPI Registry JSON

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

{
    "created_epoch": "1196553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196553600000",
    "number": "1942482997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4552 KNOLLTOP TER",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132151566",
            "telephone_number": "315-412-4350",
            "fax_number": "315-299-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4552 KNOLLTOP TER",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132151566",
            "telephone_number": "315-412-4350",
            "fax_number": "315-299-5074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "MAUREEN",
        "middle_name": "ELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-02",
        "last_updated": "2007-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02473792",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2007; 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.