Provider Demographics
NPI:1568356053
Name:ENCARNACION, ALTAGRACIA LILLIANA (LPN)
Entity type:Individual
Prefix:
First Name:ALTAGRACIA
Middle Name:LILLIANA
Last Name:ENCARNACION
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 1:154 BROOME ST APT 14G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-4023
Mailing Address - Country:US
Mailing Address - Phone:347-544-4661
Mailing Address - Fax:
Practice Address - Street 1:154 BROOME ST APT 14G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-4023
Practice Address - Country:US
Practice Address - Phone:347-544-4661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY350366164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse