Individual
CHRISTINE CANCEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
256 JAMAICA AVE, MEDFORD, NY 11763-3297
(631) 942-6987
Mailing address
256 JAMAICA AVE, MEDFORD, NY 11763-3297
(631) 942-6987
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
820024-01
NY
164W00000X
Licensed Practical Nurse
Primary
322114
NY
Other
Enumeration date
06/22/2015
Last updated
04/30/2026
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