Individual
CRYSTAL MINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1293 BIRCH ST, UNIONDALE, NY 11553-2007
(516) 830-1185
Mailing address
1293 BIRCH ST, UNIONDALE, NY 11553-2007
(516) 830-1185
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
713528-01
NY
164W00000X
Licensed Practical Nurse
304453
NY
Other
Enumeration date
05/01/2013
Last updated
04/18/2024
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