Individual
ALYSIA HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1019 COUNTY ROUTE 12, PENNELLVILLE, NY 13132-3301
(315) 415-0684
Mailing address
1019 COUNTY ROUTE 12, PENNELLVILLE, NY 13132-3301
(315) 415-0684
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
316418-1
NY
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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