Individual
MRS. SHAQUETTA A PANTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
12511 149TH AVE, SOUTH OZONE PARK, NY 11420-3717
(631) 379-6041
Mailing address
12511 149TH AVE, SOUTH OZONE PARK, NY 11420-3717
(631) 379-6041
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
339939
NY
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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