Individual
ANCY EAPEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2332 GLEASON AVE, BRONX, NY 10462
(718) 828-3203
Mailing address
2332 GLEASON AVE, BRONX, NY 10462
(718) 828-3203
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
309118
NY
Other
Enumeration date
08/31/2012
Last updated
08/31/2012
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