Individual
CAROL ANN BOISMENU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4478 HAAG RD, EDEN, NY 14057-9726
(716) 992-3055
Mailing address
4478 HAAG RD., EDEN, NY 14057
(716) 992-3055
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
078483
NY
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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