Individual
BEVERLY TAYLOR FREDENBURGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
99 WASHINGTON AVE, SUFFERN, NY 10901-6026
(845) 357-4500
(845) 357-5039
Mailing address
286 W LAKE ST, LIBERTY, NY 12754-3904
(845) 866-4181
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
273920
NY
Other
Enumeration date
07/25/2013
Last updated
07/25/2013
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