Individual
MISS AJA LEANNA SIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
19 MORTON ST, BRENTWOOD, NY 11717-2207
(631) 793-0730
Mailing address
19 MORTON ST, BRENTWOOD, NY 11717-2207
(631) 793-0730
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
334655
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
334655
—
NY
Enumeration date
03/05/2019
Last updated
03/05/2019
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