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Individual

CHYNNA FELIX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4238 MERRICK RD, MASSAPEQUA, NY 11758-6016
(631) 355-3589
Mailing address
4238 MERRICK RD, MASSAPEQUA, NY 11758-6016

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
333906
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
061326333
STATE ID
GA
Enumeration date
05/17/2019
Last updated
05/17/2019
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