Individual
MRS. COLLEEN MARIE PENNICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2 ROSEMARY CT, MANORVILLE, NY 11949-2818
(631) 281-4435
Mailing address
2 ROSEMARY CT, MANORVILLE, NY 11949-2818
(631) 281-4435
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
172851-1
NY
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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