Individual
CHIM BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
486 GARDINERS AVE, LEVITTOWN, NY 11756-3737
(516) 647-0985
Mailing address
486 GARDINERS AVE, LEVITTOWN, NY 11756-3737
(516) 647-0985
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
837988-01
NY
Other
Enumeration date
03/19/2025
Last updated
03/19/2025
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