Individual
ANNIE THELUSMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 E ARTISAN AVE, HUNTINGTON, NY 11743-6450
(917) 613-5162
Mailing address
11 E ARTISAN AVE, HUNTINGTON, NY 11743-6450
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
236461
NY
Other
Enumeration date
02/15/2011
Last updated
02/15/2011
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