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Individual

BETHANY SHENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1 MCGRATH STAND LN, SAG HARBOR, NY 11963-2830
(631) 741-8882
(631) 458-1426
Mailing address
PO BOX 1994, EAST HAMPTON, NY 11937-0908
(631) 324-9555
(631) 458-1426

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
212336
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
212336
LICENSE
NY
Enumeration date
03/20/2012
Last updated
05/23/2013
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