Individual
CARLOS MAURICIO UGARTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
58 LEONARD ST FL 1, PORT CHESTER, NY 10573-5118
(203) 898-1500
Mailing address
58 LEONARD ST FL 1, PORT CHESTER, NY 10573-5118
(203) 898-1500
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
309393
NY
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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