Individual
LESSA W BOLLERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
16 NORMANDY PL, IRVINGTON, NJ 07111-3127
(973) 342-2769
Mailing address
16 NORMANDY PL, IRVINGTON, NJ 07111-3127
(973) 342-2769
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
26NP06508500
NJ
164W00000X
Licensed Practical Nurse
Primary
302427-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001224411
—
NY
05
—
1133557796
—
NJ
Enumeration date
08/04/2011
Last updated
08/04/2011
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