Individual
MS. AUDREY SANSCULOTTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
215 ROCKAWAY TPKE, LAWRENCE, NY 11559-1216
(516) 374-5024
Mailing address
904 SMITH ST, UNIONDALE, NY 11553-3507
(516) 481-6327
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
305815
NY
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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