Individual
DAVE SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
664 E 77TH ST, BROOKLYN, NY 11236-3316
(954) 806-1140
Mailing address
664 E 77TH ST, BROOKLYN, NY 11236-3316
(954) 806-1140
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
284092
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
284092
LPN LICENSE
NY
Enumeration date
02/25/2010
Last updated
02/25/2010
About Stedi
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