Individual
DAPHNEY JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
47 SMITH AVE, BAY SHORE, NY 11706-7378
(631) 388-8611
Mailing address
47 SMITH AVE, BAY SHORE, NY 11706-7378
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
308324
NY
Other
Enumeration date
12/11/2012
Last updated
12/11/2012
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