JOHNSON EXANTUS

DEER PARK, NY
NPI1073890729
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  301511)
Enumeration Date2011-11-09
Last Update Date2011-11-09
Business Address
-- JOHNSON EXANTUS LPN
60 CROWN ST
DEER PARK, NY 11729-6921
Phone number: 631-392-0199
Mailing Address
-- JOHNSON EXANTUS LPN
60 CROWN ST
DEER PARK, NY 11729-6921
Phone number: 631-392-0199