Individual
MRS. CRYSTAL E GAMBLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
502 WELLWOOD DRIVE, SHIRLEY, NY 11967
(631) 796-0894
Mailing address
502 WELLWOOD DR, SHIRLEY, NY 11967-1115
(631) 796-0894
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
329285
NY
Other
Enumeration date
08/11/2017
Last updated
07/21/2022
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