Individual
BRANDON THEODORE MASLOSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.N.
Contact information
Practice address
19 SCHOOL DR, PORT JEFFERSON STATION, NY 11776-2920
(631) 972-8850
Mailing address
19 SCHOOL DR, PORT JEFFERSON STATION, NY 11776-2920
(631) 972-8850
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
326058
NY
Other
Enumeration date
03/26/2017
Last updated
03/26/2017
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