Individual
CARMELIE A PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11638 195TH ST, SAINT ALBANS, NY 11412-3126
(954) 529-0869
Mailing address
11638 195TH ST, SAINT ALBANS, NY 11412-3126
(954) 529-0869
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
656809-1
NY
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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