Healthcare Provider Details
I. General information
NPI: 1356649560
Provider Name (Legal Business Name): VIRGINIA EGAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/11/2011
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4311 ATLANTIC AVE FL 1
BROOKLYN NY
11224-1025
US
IV. Provider business mailing address
2213 NISKAYUNA DR
NISKAYUNA NY
12309-4011
US
V. Phone/Fax
- Phone: 518-817-0463
- Fax:
- Phone: 518-817-0463
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WC0200X |
| Taxonomy | Critical Care Medicine Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WA2000X |
| Taxonomy | Administrator Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC1400X |
| Taxonomy | College Health Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC1500X |
| Taxonomy | Community Health Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WE0003X |
| Taxonomy | Emergency Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WG0000X |
| Taxonomy | General Practice Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WH0200X |
| Taxonomy | Home Health Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WH1000X |
| Taxonomy | Hospice Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WI0500X |
| Taxonomy | Infusion Therapy Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WL0100X |
| Taxonomy | Lactation Consultant (Registered Nurse) |
| License Number | 421869 |
| License Number State | NY |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WM0102X |
| Taxonomy | Maternal Newborn Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WN0800X |
| Taxonomy | Neuroscience Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0200X |
| Taxonomy | Pediatric Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
| # 15 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WX0106X |
| Taxonomy | Occupational Health Registered Nurse |
| License Number | 421869 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
