Individual
ACHELEY JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
641 ROSE BLVD, NORTH BALDWIN, NY 11510-1026
(347) 750-9730
Mailing address
641 ROSE BLVD, NORTH BALDWIN, NY 11510-1026
(347) 750-9730
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
708911
NY
Other
Enumeration date
06/25/2021
Last updated
06/25/2021
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