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KETTLY ST SURIN LPN
NPI 1922320738
Licensed Practical Nurse in Queens Village, NY

Active since February 20, 2010
22121 JAMAICA AVE, QUEENS VILLAGE, NY 11428(917) 882-3745 Get Directions Write a Review

NPPES record last updated: October 31, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kettly St Surin Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KETTLY ST SURIN LPN (NPI 1922320738) is an individual licensed practical nurse in Queens Village, New York, licensed in New York (215736) and active in the NPI registry since February 2010.

NPPES Registry Identity

NPI1922320738
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameKETTLY ST SURINCredential: LPN
Location Address22121 JAMAICA AVEQueens Village, NY 11428-2015
Mailing Address22121 Jamaica AveQueens Village, NY 11428-2015
Phone(917) 882-3745
Sole ProprietorYes
Enumeration DateFebruary 20, 2010
Last NPPES UpdateOctober 31, 2016
✔ NPI 1922320738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in NY · 215736
Definition
A licensed practical nurse 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.
22121 JAMAICA AVE, Queens Village, NY 11428
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WAGNER GUERVIL LPN
Licensed Practical Nurse
22121 JAMAICA AVE, 2 FLOOR
QUEENS VILLAGE, NY 11428
Queens County (718) 468-6923
MARYSE VOLTAIRE
Licensed Practical Nurse
22121 JAMAICA AVE
QUEENS VILLAGE, NY 11428
Queens County (718) 468-6923
RAYMONDE DESIRE DURANDISE
Registered Nurse
22121 JAMAICA AVE
QUEENS VILLAGE, NY 11428
Queens County (718) 468-6923
ELIMENE JOSEPH LPN
Licensed Practical Nurse
22121 JAMAICA AVE, 2 FLOOR
QUEENS VILLAGE, NY 11428
Queens County (718) 468-6923
MIRIAM FARKAS
Licensed Practical Nurse
22121 JAMAICA AVE
QUEENS VILLAGE, NY 11428
Queens County (718) 468-6923
MAUVIETTE SEVERE
Licensed Practical Nurse
22121 JAMAICA AVE
QUEENS VILLAGE, NY 11428
Queens County (718) 468-6923
ADEWALE ADEBO LPN
Licensed Practical Nurse
22121 JAMAICA AVE, 2 FLOOR
QUEENS VILLAGE, NY 11428
Queens County (718) 468-6923
DENEIL ANGELLA HARDY
Skilled Nursing Facility
22121 JAMAICA AVE
QUEENS VILLAGE, NY 11428
Queens County (718) 468-6923

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kettly St Surin's NPI number?

The NPI number for Kettly St Surin is 1922320738. It was assigned to this individual provider in the NPPES registry on February 20, 2010.

Where is Kettly St Surin located?

Kettly St Surin practices at 22121 Jamaica Ave, Queens Village, NY 11428. The listed phone number is (917) 882-3745.

What is Kettly St Surin's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Kettly St Surin was last updated on October 31, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.