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Individual

MR. MACKENSDY DORMEUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
19011 LINDEN BLVD, SAINT ALBANS, NY 11412-3346
(929) 433-0054
(929) 433-0055
Mailing address
576 PINEBROOK AVE, WEST HEMPSTEAD, NY 11552-4225
(929) 433-0054
(929) 433-0055

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
NY

Other

Enumeration date
12/15/2021
Last updated
12/15/2021
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