Individual
MRS. DINA M EVANGELISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8340 SOULE RD, LIVERPOOL, NY 13090-1322
(315) 453-1151
(315) 453-1262
Mailing address
4334 POSEIDON CIR, LIVERPOOL, NY 13090-6872
(315) 453-1151
(315) 453-1262
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
369177-1
NY
Other
Enumeration date
10/11/2011
Last updated
10/11/2011
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