Individual
MS. ALICE SAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
215 CEDAR ST, HEMPSTEAD, NY 11550-5229
(516) 492-2975
(516) 492-2975
Mailing address
215 CEDAR ST, HEMPSTEAD, NY 11550-5229
(516) 492-2975
(516) 492-2975
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
186770-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01543700
—
NY
Enumeration date
11/14/2009
Last updated
11/14/2009
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