Provider Demographics
NPI:1730788167
Name:VERDINO, TAYLOR MARIE (RN)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MARIE
Last Name:VERDINO
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 1:15 LODI ST
Mailing Address - Street 2:
Mailing Address - City:ISLIP TERRACE
Mailing Address - State:NY
Mailing Address - Zip Code:11752-1605
Mailing Address - Country:US
Mailing Address - Phone:631-894-8004
Mailing Address - Fax:
Practice Address - Street 1:15 LODI ST
Practice Address - Street 2:
Practice Address - City:ISLIP TERRACE
Practice Address - State:NY
Practice Address - Zip Code:11752-1605
Practice Address - Country:US
Practice Address - Phone:631-894-8004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY765463163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse