Organization
LPN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER ROSALIA (LICENSED PRACTICAL NURSE)
16317296844
Entity
Organization
Contact information
Practice address
15 LACROSSE RD, MASTIC BEACH, NY 11951-4901
(631) 729-6844
Mailing address
15 LACROSSE RD, MASTIC BEACH, NY 11951-4901
(631) 729-6844
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
3141511
NY
Other
Enumeration date
09/24/2014
Last updated
09/24/2014
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