Individual
STACY ANN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
151 OAKLEY AVE, ELMONT, NY 11003-2534
(516) 775-2126
Mailing address
151 OAKLEY AVE, ELMONT, NY 11003-2534
(516) 775-2126
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
308542-1
NY
Other
Enumeration date
01/31/2012
Last updated
01/31/2012
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