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Individual

CARLINE AUDATE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
26 GREENTREE DR, MEDFORD, NY 11763-1682
(631) 972-7923
Mailing address
26 GREENTREE DR, MEDFORD, NY 11763-1682
(631) 972-7923

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
299651
NY

Other

Enumeration date
01/10/2012
Last updated
01/10/2012
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