Individual
ANASTAZIA MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 BERNSTEIN BLVD, CENTER MORICHES, NY 11934-1601
(631) 645-1511
Mailing address
11 BERNSTEIN BLVD, CENTER MORICHES, NY 11934-1601
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
293527-1
NY
Other
Enumeration date
11/27/2013
Last updated
11/27/2013
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