Healthcare Provider Details

I. General information

NPI: 1124807433
Provider Name (Legal Business Name): PATRICIA PINEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SUFFERN PL
SUFFERN NY
10901-5566
US

IV. Provider business mailing address

PO BOX 54
BLOOMING GROVE NY
10914-0054
US

V. Phone/Fax

Practice location:
  • Phone: 845-357-4500
  • Fax:
Mailing address:
  • Phone: 917-710-5924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number327575
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number796151
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: