Individual
MS. ANIKE ALICE EGBETOKUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
38 RIDER AVE, APT 521, PATCHOGUE, NY 11772-3900
(631) 295-7865
Mailing address
38 RIDER AVE, APT 521, PATCHOGUE, NY 11772-3900
(631) 295-7865
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
299117-1
NY
Other
Enumeration date
11/08/2009
Last updated
11/08/2009
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