Provider Demographics
NPI:1245435411
Name:DEPUY, JOYCE (LPN)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:
Last Name:DEPUY
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 1:5 SKYTOP DR APT L
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-1377
Mailing Address - Country:US
Mailing Address - Phone:914-737-1776
Mailing Address - Fax:
Practice Address - Street 1:5 SKYTOP DR APT L
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-1377
Practice Address - Country:US
Practice Address - Phone:914-737-1776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158376-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01746670Medicaid