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Individual

ALICENE THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
815 MEEHAN AVE, FAR ROCKAWAY, NY 11691-5517
(917) 640-7607
Mailing address
815 MEEHAN AVE, FAR ROCKAWAY, NY 11691-5517

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2909361
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2909361
LPN LICENSE
NY
Enumeration date
04/16/2012
Last updated
04/16/2012
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