Individual
MISS SULLYTE ELIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
121 MAIN ST, NANUET, NY 10954-2967
(845) 659-9368
Mailing address
121 MAIN ST, NANUET, NY 10954-2967
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
00194792
—
374U00000X
Home Health Aide
—
—
376K00000X
Nurse's Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699196386
NPI
—
Enumeration date
10/07/2019
Last updated
10/07/2019
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