Individual
BRIGITTE KARINA VASQUEZ MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
17 BANK AVE, SMITHTOWN, NY 11787-2703
(631) 265-5300
Mailing address
500 PECONIC ST, APT 3-1B, RONKONKOMA, NY 11779
(631) 356-8842
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
338006
NY
Other
Enumeration date
03/12/2020
Last updated
03/12/2020
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