Individual
MRS. CAROL ANN PHELAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
45 BROOK AVE, BAY SHORE, NY 11706-7416
(631) 968-1133
(631) 968-1706
Mailing address
45 BROOK AVE, BAY SHORE, NY 11706-7416
(631) 968-1133
(631) 968-1706
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
409281-1
NY
Other
Enumeration date
10/28/2011
Last updated
10/28/2011
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