Individual provider Active NPI

Jules Fabien, LPN

  • Licensed Practical Nurse
  • Elmont, NY
National Provider Identifier
1992098370
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
290515 Issued in NY
Practice address
1692 Greenway Blvd
Elmont, NY 11003-5030
Phone
(917) 574-0762
NPI assigned
May 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 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 290515 NY Primary

Addresses

Primary practice location

1692 Greenway Blvd
Elmont, NY 11003-5030

Mailing address

1692 Greenway Blvd
Elmont, NY 11003-5030
Phone (917) 574-0762

Other identifiers 1

IdentifierTypeStateIssuer
290515OtherNYLPN LICENSE

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
290515NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1992098370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1692 GREENWAY BLVD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110035030",
            "telephone_number": "917-574-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1692 GREENWAY BLVD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110035030",
            "telephone_number": "917-574-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABIEN",
        "first_name": "JULES",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-18",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "290515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPN LICENSE",
            "identifier": "290515",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.