Provider Demographics
NPI:1073899720
Name:NAUGHTON, ELEANOR MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ELEANOR
Middle Name:MARIE
Last Name:NAUGHTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:ELEANOR
Other - Middle Name:MARIE
Other - Last Name:O'HEARN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:47 SUTTON PARK RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-5635
Mailing Address - Country:US
Mailing Address - Phone:914-804-0337
Mailing Address - Fax:
Practice Address - Street 1:47 SUTTON PARK RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-5635
Practice Address - Country:US
Practice Address - Phone:914-804-0337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253691164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03396509Medicaid