Individual ProviderJanice MierischLicensed Practical NurseNursing Service ProvidersPractice Address10 Dahlia Dr W, East Patchogue, NY 11772-4860(631) 289-5585PECOS EnrollmentBased on the most recent information from CMS, provider Janice Mierisch does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1316066152Provider TypeIndividualFull NameMierisch, JaniceCredentialLPNGenderFemaleSole ProprietorYesEnumeration Date3/29/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address10 Dahlia Dr W, East Patchogue, NY 11772-4860Phone(631) 289-5585Fax(631) 289-6670Mailing LocationMailing Address10 Dahlia Dr W, East Patchogue, NY 11772-4860Phone(631) 289-5585Fax(631) 289-6670Provider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense240378-1New York