Individual
CAROLYN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 HALSEY AVE, HICKSVILLE, NY 11801-4826
(516) 942-2610
Mailing address
105 HALSEY AVE, HICKSVILLE, NY 11801-4826
(516) 942-2610
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
165841
NY
Other
Enumeration date
09/08/2008
Last updated
09/08/2008
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