Provider Demographics
NPI:1528474129
Name:WASHINGTON, SARAYA (LPN)
Entity type:Individual
Prefix:
First Name:SARAYA
Middle Name:
Last Name:WASHINGTON
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 1:3651 MEADOW LANE
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047
Mailing Address - Country:US
Mailing Address - Phone:201-779-7443
Mailing Address - Fax:
Practice Address - Street 1:100 ALDRICH ST
Practice Address - Street 2:APT 23A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4532
Practice Address - Country:US
Practice Address - Phone:201-779-7443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288965164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse