Provider Demographics
NPI:1285383026
Name:VAIL, JANICE ANN (RN)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:ANN
Last Name:VAIL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 PARKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:SOUND BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11789-3025
Mailing Address - Country:US
Mailing Address - Phone:516-459-3986
Mailing Address - Fax:516-459-3986
Practice Address - Street 1:11 PARKSIDE RD
Practice Address - Street 2:
Practice Address - City:SOUND BEACH
Practice Address - State:NY
Practice Address - Zip Code:11789-3025
Practice Address - Country:US
Practice Address - Phone:516-459-3986
Practice Address - Fax:516-459-3986
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health