Individual
CLAUDETTE BLAIR-MCDOUGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13 CLEVELAND ST, VALLEY STREAM, NY 11580-6003
(516) 823-0739
Mailing address
13 CLEVELAND ST, VALLEY STREAM, NY 11580-6003
(516) 823-0739
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
301142
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
301142
LPN LICENSE
NY
Enumeration date
02/13/2015
Last updated
02/13/2015
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