Individual
AMY LYNETTE CHAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
158 VANBUREN STREET, MASTIC, NY 11950
(631) 664-2434
Mailing address
158 VANBUREN STREET, MASTIC, NY 11950
(631) 664-2434
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
271868-1
NY
Other
Enumeration date
03/02/2010
Last updated
03/03/2010
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