Facts
- Status
- A
- Credential
- LPN
- Type
- Individual
- Enumeration date
- 2018-10-08
- Last updated
- 2018-10-08
Specialties
Licenses
- License NY
- 322352
Location
- Practice location
- 15 SUFFERN PL
- City
- SUFFERN NY
- Postal code
- 10901
- Phone
- 845-357-4500
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.