Individual
MS. CARMELLE TERRY ALEXIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3513 AVENUE L, BROOKLYN, NY 11210-5443
(646) 306-0157
Mailing address
3513 AVENUE L, BROOKLYN, NY 11210-5443
(646) 306-0157
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2586233
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02630495
—
NY
Enumeration date
08/17/2007
Last updated
08/17/2007
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