Individual
ALEXIS MICHELLE DEFREITAS-CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
429 43RD ST, COPIAGUE, NY 11726-1121
(631) 336-6849
Mailing address
429 43RD ST, COPIAGUE, NY 11726-1121
(631) 336-6849
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
309900-1
NY
Other
Enumeration date
06/19/2012
Last updated
08/15/2012
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