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Organization
KIMBERLY TALLON
Active
Organization
KIMBERLY TALLON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS KIMBERLY SUE TALLON (LICENSED PRACTICAL NURSE)
(631) 889-6178
Entity
Organization
Contact information
Practice address
10 CONNELLY DR, LAKE GROVE, NY 11755-2966
(631) 889-6178
Mailing address
10 CONNELLY DR, LAKE GROVE, NY 11755-2966
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
294449-1
NY
Other
Enumeration date
02/21/2011
Last updated
02/21/2011
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