Individual
BIANCA LEGROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 WILSON AVE, DEER PARK, NY 11729-6714
(631) 214-0319
Mailing address
22 WILSON AVE, DEER PARK, NY 11729-6714
(631) 214-0319
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
339840
NY
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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