Individual
DAMARIS HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1731 WINCORAM WAY, CORAM, NY 11727-4449
(631) 816-3757
Mailing address
1731 WINCORAM WAY, CORAM, NY 11727-4449
(631) 816-3757
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
339410-01
NY
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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