Individual
CONSTANCE SIDBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
476 W 165TH ST APT 3B, NEW YORK, NY 10032-4329
(713) 517-4949
Mailing address
476 W 165TH ST APT 3B, NEW YORK, NY 10032-4329
(713) 517-4949
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
066961
NY
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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