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AUTUMN TISO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
5 N DINGLE RD, PAWLING, NY 12564-1841
(845) 891-0934
Mailing address
16 RAILROAD ST, DOVER PLAINS, NY 12522-5341
(845) 891-0934

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
288198-1
NY

Other

Enumeration date
05/11/2010
Last updated
05/11/2010
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