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Individual

B J DIDONATO-SWINGLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
24 FAITH DR, PORT JERVIS, NY 12771-5234
(845) 978-5369
Mailing address
24 FAITH DR, PORT JERVIS, NY 12771-5234
(845) 978-5369

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
328331-1
NY

Other

Enumeration date
05/02/2019
Last updated
05/02/2019
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