Individual
MR. CHUDNEY DESARME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
190-24 111TH AVE, SAINT ALBANS, NY 11412
(917) 769-6430
Mailing address
19024 111TH AVE, SAINT ALBANS, NY 11412-2012
(917) 769-6430
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
290938-1
NY
Other
Enumeration date
08/14/2017
Last updated
07/21/2022
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