Individual
CARLA FRASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 JERUSALEM AVE FL 3, HICKSVILLE, NY 11801-4980
(516) 719-4080
Mailing address
20 JERUSALEM AVE FL 3, HICKSVILLE, NY 11801-4980
(516) 719-4080
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
292776
NY
Other
Enumeration date
07/05/2023
Last updated
08/01/2023
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