Individual
MISS CASSANDRA LEIGH HODGSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
606 MONTAUK HWY UNIT B, BAYPORT, NY 11705-1632
(631) 419-6737
Mailing address
431 BOXWOOD DR, SHIRLEY, NY 11967-1303
(631) 772-4435
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
306104-1
NY
Other
Enumeration date
04/30/2012
Last updated
04/30/2012
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