Individual
MS. PETRONA HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
13723 167TH ST, JAMAICA, NY 11434-4553
(347) 885-2998
Mailing address
13723 167TH ST, JAMAICA, NY 11434-4553
(347) 885-2998
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
281046-1
NY
Other
Enumeration date
06/18/2010
Last updated
06/18/2010
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