Individual
BRITTANY IVORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
263 BLUE POINT AVE, BLUE POINT, NY 11715-1224
(631) 690-9347
Mailing address
41 LAFAYETTE AVE, MASTIC, NY 11950-2815
(631) 578-8836
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
340070
NY
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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