Individual
MR. BILLY RAY PARKER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
2 BABYLON TPKE APT 21, ROOSEVELT, NY 11575-2168
(516) 300-2288
Mailing address
PO BOX 1135, ROOSEVELT, NY 11575-0635
(516) 300-2288
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
292261
NY
Other
Enumeration date
08/22/2012
Last updated
08/22/2012
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