Individual
MISS CRYSTAL E WASIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2592 CAMBRIA WILSON RD, WILSON, NY 14172-9703
(716) 462-1347
Mailing address
2592 CAMBRIA WILSON RD, WILSON, NY 14172-9703
(716) 462-1347
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
312299-1
NY
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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