Individual
CELENA GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
70 LOCKE RD, GROTON, NY 13073-5400
(607) 351-0515
Mailing address
70 LOCKE RD, GROTON, NY 13073-5400
(607) 351-0515
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
320347
NY
Other
Enumeration date
01/24/2019
Last updated
01/24/2019
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