Individual
MRS. CAROL ANN BALESTRACCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
31 NAVAJO CT, CORAM, NY 11727-1516
(631) 474-8272
Mailing address
31 NAVAJO CT, CORAM, NY 11727-1516
(631) 474-8272
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
295877
NY
Other
Enumeration date
07/12/2011
Last updated
07/12/2011
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