Provider Demographics
NPI:1578006318
Name:AMUSO, JOANNE (LPN)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:AMUSO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 E GANSEVOORT ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13365-1451
Mailing Address - Country:US
Mailing Address - Phone:315-292-3754
Mailing Address - Fax:
Practice Address - Street 1:567 E GANSEVOORT ST
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NY
Practice Address - Zip Code:13365-1451
Practice Address - Country:US
Practice Address - Phone:315-292-3754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322569-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse