STEPHEN JAMES CZACHOR - NPI NUMBER 1699078584

Summary

Provider Name: STEPHEN JAMES CZACHOR

NPI Number: 1699078584

Clasification: Licensed Practical Nurse (164W00000X)

Address:
4 NORFOLK CT
CORAM, NY
ZIP 11727

Phone Number: (631) 949-0799



Detailed Information

Stephen James Czachor is a licensed practical nurse in Coram, NY. The provider is an individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. The assigned NPI number for this provider is 1699078584 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

4 NORFOLK CT
CORAM, NY
ZIP 11727-636
Phone: (631) 949-0799

The enumeration date for this NPI number is 12/15/2010 and was last updated on 12/15/2010.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 164W00000X Licensed Practical Nurse 303741 NY Yes

NPI Record

No. Field Name Field Value
1 NPI 1699078584
2 Entity Type Code 1
3 Provider Last Name Legal Name CZACHOR
4 Provider First Name STEPHEN
5 Provider Middle Name JAMES
6 Provider First Line Business Practice Location Address 4 NORFOLK CT
7 Provider Business Practice Location Address City Name CORAM
8 Provider Business Practice Location Address State Name NY
9 Provider Business Practice Location Address Postal Code 117271636
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 6319490799
12 Provider Enumeration Date 12/15/2010
13 Last Update Date 12/15/2010
14 Provider Gender Code M
15 Healthcare Provider Taxonomy Code 1 164W00000X
16 Provider License Number 1 303741
17 Provider License Number State Code 1 NY
18 Healthcare Provider Primary Taxonomy Switch 1 Y
19 Is Sole Proprietor N

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This page was last updated on: 10/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.