DAVIDSON BASTIEN

BRENTWOOD, NY
NPI1073935359
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  313554)
Enumeration Date2014-01-06
Last Update Date2014-01-06
Business Address
-- DAVIDSON BASTIEN
27 MONROE AVE
BRENTWOOD, NY 11717-3917
Phone number: 631-839-3621
Mailing Address
-- DAVIDSON BASTIEN
27 MONROE AVE
BRENTWOOD, NY 11717-3917
Phone number: