Provider Demographics
NPI:1952652653
Name:WYREMSKI, EILEEN M (RN)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:M
Last Name:WYREMSKI
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 1:170 ROCKAWAY AVE
Mailing Address - Street 2:GARDEN CITY HIGH SCHOOL
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1430
Mailing Address - Country:US
Mailing Address - Phone:516-478-2030
Mailing Address - Fax:516-408-7251
Practice Address - Street 1:170 ROCKAWAY AVE
Practice Address - Street 2:GARDEN CITY HIGH SCHOOL
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1430
Practice Address - Country:US
Practice Address - Phone:516-478-2030
Practice Address - Fax:516-408-7251
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311681163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse