Individual
MISS CUPIDANA ST BASTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3127 TIEMANN AVE, APT#1, BRONX, NY 10469-3118
(347) 200-4905
Mailing address
3127 TIEMANN AVE, APT#1, BRONX, NY 10469-3118
(347) 200-4905
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
283533-1
NY
Other
Enumeration date
02/14/2008
Last updated
02/14/2008
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