Individual
LARICIA ALLSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
64 ELDER DR, MASTIC BEACH, NY 11951-6323
(631) 399-2149
Mailing address
64 ELDER DR, MASTIC BEACH, NY 11951-6323
(631) 399-2149
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
342016270803E
NY
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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