Provider Demographics
NPI:1255608287
Name:PENDEL, EVELYN (RN)
Entity type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:
Last Name:PENDEL
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 1:27 FIRTREE LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4011
Mailing Address - Country:US
Mailing Address - Phone:631-683-4367
Mailing Address - Fax:
Practice Address - Street 1:82 TURKEY LN
Practice Address - Street 2:
Practice Address - City:COLD SPRING HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11724-1703
Practice Address - Country:US
Practice Address - Phone:631-367-6904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY391585-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse