Individual
CAROLYN WYHOWANEC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16B VAN WICKLEN CT, NORTHPORT, NY 11768-2139
(631) 418-7964
Mailing address
16B VAN WICKLEN CT, NORTHPORT, NY 11768-2139
(631) 418-7964
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
263609-1
NY
Other
Enumeration date
02/17/2012
Last updated
03/30/2012
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