Individual provider Active NPI

Marie Webblen Vallon, LPN

  • Licensed Practical Nurse
  • Woodhaven, NY
National Provider Identifier
1962787069
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
304467 Issued in NY
Practice address
9133 79TH St
Woodhaven, NY 11421-2909
Phone
(347) 813-8777
NPI assigned
Oct 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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 304467 NY Primary

Addresses

Primary practice location

9133 79TH St
Woodhaven, NY 11421-2909

Mailing address

9133 79TH St
Woodhaven, NY 11421-2909
Phone (347) 813-8777

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
304467NYMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1962787069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9133 79TH ST",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114212909",
            "telephone_number": "347-813-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9133 79TH ST",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114212909",
            "telephone_number": "347-813-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLON",
        "first_name": "MARIE",
        "middle_name": "WEBBLEN",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "304467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodhaven, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.