Individual
MS. BETTY J VANDIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
508 AIRPORT EXECUTIVE PARK, NANUET, NY 10954-5238
(845) 425-2655
Mailing address
33 OAK ST, APT. 6C, WHITE PLAINS, NY 10603-2642
(914) 437-5331
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
231021
NY
Other
Enumeration date
02/17/2010
Last updated
02/17/2010
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