Active NPI
Mary Wysocki, RN
- Registered Nurse
- Manorville, NY
National Provider Identifier
1942601166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 290144-1
- Practice address
- 54 Manorview Way
Manorville, NY 11949-2975 - Phone
- (631) 801-2110
- NPI assigned
- Sep 7, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 290144-1 | NY | Primary |
Addresses
Primary practice location
54 Manorview Way
Manorville, NY 11949-2975
Mailing address
54 Manorview Way
Manorville, NY 11949-2975
Phone (631) 801-2110
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 290144-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410048000000",
"number": "1942601166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 MANORVIEW WAY",
"city": "MANORVILLE",
"state": "NY",
"postal_code": "119492975",
"telephone_number": "631-801-2110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 MANORVIEW WAY",
"city": "MANORVILLE",
"state": "NY",
"postal_code": "119492975",
"telephone_number": "631-801-2110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYSOCKI",
"first_name": "MARY",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-07",
"last_updated": "2014-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "290144-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manorville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.