Individual
CARDENE CRESTEL WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
106 WINTHROP AVE, NEW ROCHELLE, NY 10801-3313
(914) 433-5331
Mailing address
106 WINTHROP AVE, NEW ROCHELLE, NY 10801-3313
(914) 433-5331
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
169322-1
NY
Other
Enumeration date
02/27/2008
Last updated
03/21/2008
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