Healthcare Provider Details

I. General information

NPI: 1811100415
Provider Name (Legal Business Name): TERRI ANNE FEDERIGHI LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 STILLWATER RD MICHEAL DALY
MAHOPAC NY
10541
US

IV. Provider business mailing address

134 SO VACATION DR
WAPPINGERS NY
12590
US

V. Phone/Fax

Practice location:
  • Phone: 845-628-0373
  • Fax:
Mailing address:
  • Phone: 845-226-1729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN 243609
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: