Individual
DARLENE BEAUCICOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 MARK LN, DEER PARK, NY 11729-6411
(516) 451-1142
Mailing address
4 MARK LN, DEER PARK, NY 11729-6411
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
336634-01
NY
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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