Individual
LOURDES AGLAEE JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
1711 BROOKHAVEN AVE, FAR ROCKAWAY, NY 11691-4406
(718) 869-8000
Mailing address
1711 BROOKHAVEN AVE, FAR ROCKAWAY, NY 11691-4406
(718) 869-8000
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
506185
NY
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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