Individual
BRAULIO FERNANDO GUALLPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
674 MAIN ST, FL. 2, PEEKSKILL, NY 10566-2013
(914) 930-9313
Mailing address
674 MAIN ST, FL. 2, PEEKSKILL, NY 10566-2013
(914) 930-9313
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
321073
NY
Other
Enumeration date
03/30/2015
Last updated
03/30/2015
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