Provider Demographics
NPI:1871781856
Name:MCNESHIE, DIANNE (LPN)
Entity type:Individual
Prefix:
First Name:DIANNE
Middle Name:
Last Name:MCNESHIE
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 1:17020 130TH AVE
Mailing Address - Street 2:SUITE 7E
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3283
Mailing Address - Country:US
Mailing Address - Phone:646-242-6683
Mailing Address - Fax:646-242-6683
Practice Address - Street 1:17020 130TH AVE
Practice Address - Street 2:SUITE 7E
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3283
Practice Address - Country:US
Practice Address - Phone:646-242-6683
Practice Address - Fax:646-242-6683
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242949164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY242949OtherNY LICENSE NUMBER
113465690OtherEMPLOYER TIN