Individual
ALFONSO JAMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1127 NAMEOKE ST, FAR ROCKAWAY, NY 11691-4722
(347) 526-2961
Mailing address
1127 NAMEOKE ST, FAR ROCKAWAY, NY 11691-4722
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
305919
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972044501
—
NY
Enumeration date
11/08/2017
Last updated
11/08/2017
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