Provider Demographics
NPI:1629687801
Name:GHANSIAM, ALANA V (RN)
Entity Type:Individual
Prefix:MISS
First Name:ALANA
Middle Name:V
Last Name:GHANSIAM
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 1:9110 187TH PL
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2410
Mailing Address - Country:US
Mailing Address - Phone:347-975-8738
Mailing Address - Fax:
Practice Address - Street 1:9110 187TH PL
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2410
Practice Address - Country:US
Practice Address - Phone:347-975-8738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY754477-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse