Provider Demographics
NPI:1093144420
Name:HAY, PEARLIE (LPN)
Entity Type:Individual
Prefix:MS
First Name:PEARLIE
Middle Name:
Last Name:HAY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:PEARLIE
Other - Middle Name:
Other - Last Name:GRANGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:75 W END AVE
Mailing Address - Street 2:APT C3O
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7853
Mailing Address - Country:US
Mailing Address - Phone:917-995-1576
Mailing Address - Fax:
Practice Address - Street 1:13 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-6003
Practice Address - Country:US
Practice Address - Phone:516-823-0739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY315239251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health