Individual provider Active NPI

Pat Pallace, L.P.N.

  • Licensed Practical Nurse
  • Hauppauge, NY
National Provider Identifier
1962713990
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
153909 Issued in NY
Practice address
888 Veterans Memorial Hwy
Suite 210
Hauppauge, NY 11788-2950
Phone
(631) 232-6030
NPI assigned
Jun 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 153909 NY Primary

Addresses

Primary practice location

888 Veterans Memorial Hwy
Suite 210
Hauppauge, NY 11788-2950

Mailing address

888 Veterans Memorial Hwy
Suite 210
Hauppauge, NY 11788-2950
Phone (631) 232-6030

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
153909NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1962713990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 210",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882950",
            "telephone_number": "631-232-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 210",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882950",
            "telephone_number": "631-232-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLACE",
        "first_name": "PAT",
        "credential": "L.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "153909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.