Individual
ANGELINA TAVERAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 PIOXI ST, COPIAGUE, NY 11726-2136
(321) 663-4973
Mailing address
100 PIOXI ST, COPIAGUE, NY 11726-2136
(321) 663-4973
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
322190-1
NY
Other
Enumeration date
09/15/2015
Last updated
09/15/2015
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