Individual
ANDREA SHANNEL DACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2369 2ND AVE, NEW YORK, NY 10035-3108
(212) 876-2300
(212) 369-8209
Mailing address
2369 2ND AVE, NEW YORK, NY 10035-3108
(212) 876-2300
(212) 369-8209
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
314567-01
NY
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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