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Individual

MS. LEISA KAY DWYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
183 WEBSTER STREET, DAVIS ELEMENTARY, MALONE, NY 12953
(518) 483-7802
(518) 483-6390
Mailing address
P.O. BOX 847, 42 HUSKIE LANE, MALONE, NY 12953
(518) 483-7800
(518) 483-3071

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
493695-1(RNLICENSE)
NY

Other

Enumeration date
04/04/2012
Last updated
04/04/2012
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