Individual
MS. CYNTHIA LOUISE SPROUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
20 HOLBROOK STREET, PATCHOGUE, NY 11772-1616
(631) 654-4050
Mailing address
20 HOLBROOK STREET, PATCHOGUE, NY 11772-1616
(631) 654-4050
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2810371
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02753780
—
NY
Enumeration date
08/22/2007
Last updated
08/22/2007
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