Provider Demographics
NPI:1043667827
Name:VANESSA DESHOMMES
Entity type:Organization
Organization Name:VANESSA DESHOMMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MISS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESHOMMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-482-6281
Mailing Address - Street 1:112 N 18TH ST
Mailing Address - Street 2:
Mailing Address - City:WHEATLEY HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11798-1803
Mailing Address - Country:US
Mailing Address - Phone:631-482-6281
Mailing Address - Fax:
Practice Address - Street 1:112 N 18TH ST
Practice Address - Street 2:
Practice Address - City:WHEATLEY HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11798-1803
Practice Address - Country:US
Practice Address - Phone:631-482-6281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7149801251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care