Individual
MAGALIE ALTIDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
122 S 29TH ST, WYANDANCH, NY 11798-2705
(631) 643-0560
Mailing address
122 S 29TH ST, WYANDANCH, NY 11798-2705
(631) 643-0560
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
330311880490E
NY
Other
Enumeration date
12/10/2012
Last updated
12/10/2012
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