Provider Demographics
NPI:1770766818
Name:DEACON, CLAIRE ELAINE (LPN)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ELAINE
Last Name:DEACON
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 1:42 JORDAN DR
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:NY
Mailing Address - Zip Code:12563-2037
Mailing Address - Country:US
Mailing Address - Phone:845-264-1898
Mailing Address - Fax:
Practice Address - Street 1:42 JORDAN DR
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:NY
Practice Address - Zip Code:12563-2037
Practice Address - Country:US
Practice Address - Phone:845-264-1898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238785-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse