Provider Demographics
NPI:1972794006
Name:SCULLY, JANET ELIZABETH (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:ELIZABETH
Last Name:SCULLY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 MARIETTA AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1436
Mailing Address - Country:US
Mailing Address - Phone:914-741-6720
Mailing Address - Fax:
Practice Address - Street 1:340 MARIETTA AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-1436
Practice Address - Country:US
Practice Address - Phone:914-741-6720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY346891163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse