Provider Demographics
NPI:1861800112
Name:GREENWOOD, DANESHER DANSALEE (LPN)
Entity type:Individual
Prefix:MISS
First Name:DANESHER
Middle Name:DANSALEE
Last Name:GREENWOOD
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 1:2434 BEAUMONT AVE
Mailing Address - Street 2:APT. 3A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-6393
Mailing Address - Country:US
Mailing Address - Phone:347-785-6010
Mailing Address - Fax:
Practice Address - Street 1:2434 BEAUMONT AVE
Practice Address - Street 2:APT. 3A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-6393
Practice Address - Country:US
Practice Address - Phone:347-785-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY318305-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse