KELLIE ANNE LIWANAG RN NPI 1679080493

NPI Information

  • NPI: 1679080493
  • Provider Name: KELLIE ANNE LIWANAG, RN
  • Classification: Registered Nurse - 163WP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • Address: 777 SEAVIEW AVE
    STATEN ISLAND, NY
    ZIP 10305
  • Phone: (718) 667-2300

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NPI Details

Kellie Anne Liwanag, RN is a psychiatric/mental health registered nurse in Staten Island, NY. Kellie Anne Liwanag, RN NPI is 1679080493. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

777 SEAVIEW AVE
STATEN ISLAND, NY
ZIP 10305-409
Phone: (718) 667-2300

The enumeration date for this NPI number is 1/2/2018 and was last updated on 1/2/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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
1163WP0808XRegistered NursePsychiatric/Mental Health458372-1NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12997157MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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