Provider Demographics
NPI:1407976426
Name:MUSA, VERONICA LOUISE (RN)
Entity Type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:LOUISE
Last Name:MUSA
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 1:310 MYERS RD
Mailing Address - Street 2:
Mailing Address - City:NEVERSINK
Mailing Address - State:NY
Mailing Address - Zip Code:12765-5007
Mailing Address - Country:US
Mailing Address - Phone:845-985-7407
Mailing Address - Fax:
Practice Address - Street 1:34 MOORE HILL RD
Practice Address - Street 2:
Practice Address - City:GRAHAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12740-5605
Practice Address - Country:US
Practice Address - Phone:845-985-2296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY475000163W00000X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01800568Medicaid