Individual
ALISSA KAVUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
30 TAPPAN AVE, ISLIP, NY 11751-4106
(631) 452-6022
Mailing address
30 TAPPAN AVE, ISLIP, NY 11751-4106
(631) 452-6022
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
325024
NY
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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