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Individual

MR. JOSE WILMER TENESACA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.P.N

Contact information

Practice address
38 LAKE AVE, DANBURY, CT 06810-6345
(203) 512-9681
Mailing address
38 LAKE AVE, DANBURY, CT 06810-6345
(203) 512-9681

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
286723-1
NY

Other

Enumeration date
05/24/2016
Last updated
05/24/2016
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