Organization
PRIVATE DUTY NURSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARDENE WALLACE LPN (LPN)
(914) 433-5331
Entity
Organization
Contact information
Practice address
106 WINTHROP AVE, 2ND FLOOR, NEW ROCHELLE, NY 10801-3313
(914) 433-5331
Mailing address
106 WINTHROP AVE, 2ND FLOOR, NEW ROCHELLE, NY 10801
(914) 433-5331
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
169322-1
NY
Other
Enumeration date
02/12/2008
Last updated
02/12/2008
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