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Individual

MRS. BARBARA JEAN BENDER KIVAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
14 BELLEMEADE AVE, SMITHTOWN, NY 11787-1857
(631) 265-5300
Mailing address
54 CHARM CITY DR, PORT JEFFERSON STATION, NY 11776-1360
(631) 991-5886

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
294772-1
NY

Other

Enumeration date
01/25/2010
Last updated
01/25/2010
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