Individual
CRYSTAL TANZOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
95 MAIN ST, APT 4, UNADILLA, NY 13849-3406
(631) 413-6770
Mailing address
PO BOX 851, UNADILLA, NY 13849-0851
(631) 413-6770
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
1164WOOOOOX
NY
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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