Provider Demographics
NPI:1265793830
Name:PLAISIMOND, FAIMIE (BACHELOR IN NURSING)
Entity type:Individual
Prefix:MRS
First Name:FAIMIE
Middle Name:
Last Name:PLAISIMOND
Suffix:
Gender:F
Credentials:BACHELOR IN NURSING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 BRIGHTSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722
Mailing Address - Country:US
Mailing Address - Phone:631-415-4066
Mailing Address - Fax:163-164-3117
Practice Address - Street 1:169 NORTH 28 TH ST
Practice Address - Street 2:
Practice Address - City:WYANDANCH
Practice Address - State:NY
Practice Address - Zip Code:11798-2008
Practice Address - Country:US
Practice Address - Phone:631-415-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY579485163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse