Individual
CARA MARIE BAGNATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
15 PONDWAY, APT 1, MANORVILLE, NY 11949-2222
(631) 988-8177
Mailing address
15 PONDWAY, APT 1, MANORVILLE, NY 11949-2222
(631) 988-8177
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
267838-1
NY
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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