Individual
MRS. BROOKE Y TAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
45 MERRIEWOLD LN N, MONROE, NY 10950-1912
(845) 216-9636
Mailing address
45 MERRIEWOLD LN N, MONROE, NY 10950-1912
(845) 216-9636
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
313189-1
NY
Other
Enumeration date
02/17/2013
Last updated
02/17/2013
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