Provider Demographics
NPI:1932451762
Name:GAINEY, ENA LOUISE (LPN)
Entity type:Individual
Prefix:MISS
First Name:ENA
Middle Name:LOUISE
Last Name:GAINEY
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 1:236 E 28TH ST
Mailing Address - Street 2:APT 2E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6375
Mailing Address - Country:US
Mailing Address - Phone:347-209-5841
Mailing Address - Fax:
Practice Address - Street 1:236 E 28TH ST
Practice Address - Street 2:APT 2E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6375
Practice Address - Country:US
Practice Address - Phone:347-209-5841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215995164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC045170OtherBOARD OF NURSING