Provider Demographics
NPI:1497032361
Name:MCCONWAY-VESPE, ELLEN (RN)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:
Last Name:MCCONWAY-VESPE
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 1:999 HERRICKS RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1320
Mailing Address - Country:US
Mailing Address - Phone:516-305-8939
Mailing Address - Fax:
Practice Address - Street 1:99 SHELTER ROCK RD
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1355
Practice Address - Country:US
Practice Address - Phone:516-305-8885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY350845-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool