Individual
BROOKE L BICKFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 HAWTHORNE AVE, EAST ISLIP, NY 11730-1927
(516) 305-2859
Mailing address
130 HAWTHORNE AVE, EAST ISLIP, NY 11730-1927
(516) 305-2859
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
336821
NY
Other
Enumeration date
09/10/2020
Last updated
09/10/2020
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