Individual
AVALON RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CROSS ISLAND PLZ, ROSEDALE, NY 11422-1465
(516) 823-0739
Mailing address
1 CROSS ISLAND PLZ, ROSEDALE, NY 11422-1465
(516) 823-0739
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
314321
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
314321
NSO
NY
Enumeration date
09/04/2013
Last updated
09/04/2013
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