Provider Demographics
NPI:1659824043
Name:BISHOP, JANET (LPN)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:BISHOP
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 1:24 BAYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-3216
Mailing Address - Country:US
Mailing Address - Phone:516-652-0245
Mailing Address - Fax:
Practice Address - Street 1:24 BAYVIEW DR
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-3216
Practice Address - Country:US
Practice Address - Phone:516-652-0245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY325536-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse