Individual
CAROL YVONNE KENYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9715 64TH RD, REGO PARK, NY 11374-2250
(718) 459-5592
(718) 459-6047
Mailing address
803 N WILLIAM ST, NORTH BALDWIN, NY 11510-1436
(516) 765-1203
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
235078-1
NY
Other
Enumeration date
11/22/2010
Last updated
11/22/2010
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