Provider Demographics
NPI:1023153384
Name:ORLANDO, TERRY
Entity type:Individual
Prefix:MS
First Name:TERRY
Middle Name:
Last Name:ORLANDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 CRYSTAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:AQUEBOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11931-0363
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:116 CRYSTAL DRIVE
Practice Address - Street 2:
Practice Address - City:AQUEBOGUE
Practice Address - State:NY
Practice Address - Zip Code:11931-0363
Practice Address - Country:US
Practice Address - Phone:631-722-5096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY456093-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02749484Medicaid