Provider Demographics
NPI:1093509838
Name:GEEVARGHESE, LNU
Entity type:Individual
Prefix:
First Name:LNU
Middle Name:
Last Name:GEEVARGHESE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3915
Mailing Address - Country:US
Mailing Address - Phone:516-643-8277
Mailing Address - Fax:
Practice Address - Street 1:12 EVERGREEN AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-3915
Practice Address - Country:US
Practice Address - Phone:516-643-8277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY591898163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse