Individual
MRS. BERNICE A AJAVON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
778 WINONA BLVD, ROCHESTER, NY 14617-2961
(585) 750-1191
Mailing address
778 WINONA BLVD, ROCHESTER, NY 14617-2961
(585) 750-1191
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
128126
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02069221
—
NY
Enumeration date
05/22/2007
Last updated
07/09/2007
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