Individual
CYNTHIA LACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2525 OCEAN AVE, RONKONKOMA, NY 11779-6016
(631) 676-6285
Mailing address
2525 OCEAN AVE, RONKONKOMA, NY 11779-6016
(631) 676-6285
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
535996-1
NY
Other
Enumeration date
11/23/2007
Last updated
11/23/2007
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