Individual
MRS. GEORGIA MARIE VANAGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
200 3RD AVE, EAST NORTHPORT, NY 11731
(631) 368-2060
Mailing address
200 3RD AVE, EAST NORTHPORT, NY 11731
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
112084-1
NY
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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