Provider Demographics
NPI:1700264207
Name:CUMMINGS, MONIQUE (RN)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:CUMMINGS
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 1:25 LUPIDIA ST
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-1516
Mailing Address - Country:US
Mailing Address - Phone:347-813-7055
Mailing Address - Fax:631-608-0633
Practice Address - Street 1:25 LUPIDIA ST
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-1516
Practice Address - Country:US
Practice Address - Phone:347-813-7055
Practice Address - Fax:631-608-0633
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY699551163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse