Individual
DORIS YANETH VACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
147 E BROADWAY, MONTICELLO, NY 12701-8802
(845) 866-2511
Mailing address
147 E BROADWAY, MONTICELLO, NY 12701-8802
(845) 866-2511
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
649357-1
NY
Other
Enumeration date
05/17/2013
Last updated
05/17/2013
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