Provider Demographics
NPI:1356649560
Name:EGAN, VIRGINIA (RN)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:EGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2213 NISKAYUNA DR
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-4011
Mailing Address - Country:US
Mailing Address - Phone:518-817-0463
Mailing Address - Fax:
Practice Address - Street 1:4311 ATLANTIC AVE FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-1025
Practice Address - Country:US
Practice Address - Phone:518-817-0463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-11
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY421869163WC0200X, 163WA2000X, 163WC1400X, 163WC1500X, 163WE0003X, 163WG0000X, 163WH0200X, 163WH1000X, 163WI0500X, 163WL0100X, 163WM0102X, 163WN0800X, 163WP0200X, 163WP0808X, 163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC1400XNursing Service ProvidersRegistered NurseCollege Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WX0106XNursing Service ProvidersRegistered NurseOccupational Health