Individual
DAPHNEY BOURJOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DAPHNEY BOURJOLLY
Contact information
Practice address
125 HAWTHORNE AVE, 346, CENTRAL ISLIP, NY 11722-1367
(631) 327-6969
(631) 623-6152
Mailing address
125 HAWTHORNE AVE, 346, CENTRAL ISLIP, NY 11722-1367
(631) 327-6969
(631) 623-6152
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304080
NY
Other
Enumeration date
01/06/2011
Last updated
01/06/2011
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