Provider Demographics
NPI:1033323621
Name:ST ALBAMS NURSING REGISTRY INC
Entity Type:Organization
Organization Name:ST ALBAMS NURSING REGISTRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:T
Authorized Official - Last Name:SALMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-464-3149
Mailing Address - Street 1:113-12 200TH STREET
Mailing Address - Street 2:
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11412
Mailing Address - Country:US
Mailing Address - Phone:718-464-3149
Mailing Address - Fax:718-766-0873
Practice Address - Street 1:113-12 200TH STREET
Practice Address - Street 2:
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11412
Practice Address - Country:US
Practice Address - Phone:718-464-3149
Practice Address - Fax:718-766-0873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1066L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02514478Medicaid