Individual
CHINAEDU S ASIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
74 MILL DR, MASTIC BEACH, NY 11951-1403
(631) 657-6038
Mailing address
25 BETSY ROSS DR, BOHEMIA, NY 11716-4003
(516) 810-0109
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
314814-1
NY
Other
Enumeration date
09/25/2013
Last updated
09/25/2013
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