Individual
MRS. ALIZA DIANNE CHIQUITUCTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
310 FORSYTHE AVE, LINDENHURST, NY 11757-2204
(516) 554-1209
Mailing address
73 HAGERMAN AVE, MEDFORD, NY 11763-2131
(516) 554-1209
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
636154
NY
Other
Enumeration date
05/04/2011
Last updated
05/01/2018
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