Individual
ALEXA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9 WICHARD DR, OAKDALE, NY 11769-1513
(631) 873-7389
Mailing address
9 WICHARD DR, OAKDALE, NY 11769-1513
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
306197
NY
Other
Enumeration date
01/04/2020
Last updated
01/04/2020
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