Individual
CASSANDRA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23214 MERRICK BLVD, LAURELTON, NY 11413-2115
(718) 528-3432
Mailing address
23214 MERRICK BLVD, LAURELTON, NY 11413-2115
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
330701
NY
Other
Enumeration date
12/13/2017
Last updated
12/13/2017
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