Individual
MISS CHRISTINE CHARLOTTE HEIDENRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
263 BLUE POINT AVE, BLUE POINT, NY 11715-1224
(631) 419-6737
Mailing address
263 BLUE POINT AVE, BLUE POINT, NY 11715-1224
(631) 419-6737
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
307277
NY
Other
Enumeration date
06/01/2012
Last updated
06/01/2012
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