Individual
MS. JACQUELINE DIANNE LYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
175A CALEBS PATH, CENTRAL ISLIP, NY 11722-1036
(631) 439-1448
Mailing address
175A CALEBS PATH, CENTRAL ISLIP, NY 11722-1036
(631) 439-1448
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
571191
NY
Other
Enumeration date
07/09/2009
Last updated
07/09/2009
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