Provider Demographics
NPI:1275375107
Name:SEALEY, THANDEKA ERIKA (LPN)
Entity type:Individual
Prefix:
First Name:THANDEKA
Middle Name:ERIKA
Last Name:SEALEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 TALMADGE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1548
Mailing Address - Country:US
Mailing Address - Phone:516-710-8149
Mailing Address - Fax:
Practice Address - Street 1:1461 TALMADGE DR
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-1548
Practice Address - Country:US
Practice Address - Phone:516-710-8149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343632-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse