Individual
MISS CARLY M DELVALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1378 HIRAM AVE, HOLBROOK, NY 11741-5709
(516) 356-0723
Mailing address
1378 HIRAM AVE, HOLBROOK, NY 11741-5709
(516) 356-0723
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
300245-1
NY
Other
Enumeration date
08/23/2011
Last updated
08/23/2011
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