Individual
ANDREA TOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
460 BRIELLE AVE BLDG H, STATEN ISLAND, NY 10314-6427
(718) 816-6589
Mailing address
9 INNIS ST, STATEN ISLAND, NY 10302-1129
(347) 517-5647
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
310972-1
NY
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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