Provider Demographics
NPI:1629399878
Name:SEARS, VINCENT (LPN)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:SEARS
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 LINWOOD PLZ
Mailing Address - Street 2:APT-156
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3701
Mailing Address - Country:US
Mailing Address - Phone:718-671-2100
Mailing Address - Fax:
Practice Address - Street 1:96 LINWOOD PLZ
Practice Address - Street 2:APT-156
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-3701
Practice Address - Country:US
Practice Address - Phone:718-671-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300240164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse