Individual
MRS. BIBI K WETHINGTON-ROGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
22018 109TH AVE, QUEENS VILLAGE, NY 11429-2515
(646) 530-2351
Mailing address
22018 109TH AVE, QUEENS VILLAGE, NY 11429-2515
(646) 530-2351
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
313160
NY
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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