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General NPI Number Information
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NPI Number | 1194113522
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Entity Type | Individual
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Provider Name | ATHALEE WATSON RN
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Gender | Female
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 72 4TH ST
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City | BRENTWOOD
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State | NY
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Zip | 11717-5532
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Country | US
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Telephone | 631-415-3839
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Fax |
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Provider Business Mailing Address
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Address Line | 72 4TH ST
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City | BRENTWOOD
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State | NY
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Zip | 11717-5532
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Country | US
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Telephone | 631-415-3839
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Fax | 631-273-0215
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | N26575
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 268391
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | N26575
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License Number State | NY
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