Individual
PROF. DALE ARMETTA DOUGLAS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N
Contact information
Practice address
130 MALLARD BAY, CHITTENANGO, NY 13037-9553
(315) 633-0136
Mailing address
130 MALLARD BAY, CHITTENANGO, NY 13037-9553
(315) 633-0136
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
118687
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02833356
—
NY
Enumeration date
10/16/2007
Last updated
10/16/2007
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