Individual
MS. IMELDA BOLANO LABORCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1677 EARL ST, UNION, NJ 07083-5533
(908) 686-8782
(908) 687-4198
Mailing address
1677 EARL ST, UNION, NJ 07083-5533
(908) 686-8782
(908) 687-4198
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
205105
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01817647
—
NY
Enumeration date
06/01/2007
Last updated
07/08/2007
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