Individual
BENNESA JULIE BURBATSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
26 RAYBOR RD, COMMACK, NY 11725-4412
(631) 357-9421
Mailing address
26 RAYBOR RD, COMMACK, NY 11725-4412
(631) 357-9421
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
324989-1
NY
Other
Enumeration date
10/21/2017
Last updated
10/21/2017
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