Individual
MS. CARMEN RUVOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
543 MORICHES MIDDLE ISLAND RD, MANORVILLE, NY 11949-2121
(631) 874-6750
(631) 874-6785
Mailing address
543 MORICHES MIDDLE ISLAND RD, MANORVILLE, NY 11949-2121
(631) 874-6750
(631) 874-6785
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10197523
NY
Other
Enumeration date
10/25/2012
Last updated
10/25/2012
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