Provider Demographics
NPI:1235895285
Name:SIENKIEWICZ, ANN (LPN)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:SIENKIEWICZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:KUSTAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:200 SALT POINT TPKE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-1018
Mailing Address - Country:US
Mailing Address - Phone:845-454-2000
Mailing Address - Fax:
Practice Address - Street 1:20 MOLLYS WAY
Practice Address - Street 2:
Practice Address - City:SALT POINT
Practice Address - State:NY
Practice Address - Zip Code:12578-3109
Practice Address - Country:US
Practice Address - Phone:845-266-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286799-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse