Individual provider Active NPI

Ketty Polynice

  • School Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1962713826
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
430899 Issued in NY
Practice address
1558 Canarsie Rd FL 1
Brooklyn, NY 11236-5204
Phone
(718) 344-3700
NPI assigned
Jun 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 430899 NY Primary

Addresses

Primary practice location

1558 Canarsie Rd FL 1
Brooklyn, NY 11236-5204

Mailing address

1558 Canarsie Rd FL 1
Brooklyn, NY 11236-5204
Phone (718) 344-3700

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
430899NYMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1962713826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1558 CANARSIE RD FL 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365204",
            "telephone_number": "718-344-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1558 CANARSIE RD FL 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365204",
            "telephone_number": "718-344-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLYNICE",
        "first_name": "KETTY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "430899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.