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1093090557
CARLY M PREMO
TROY, NY
NPI
1093090557
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: NY 645882)
Enumeration Date
2011-10-17
Last Update Date
2011-10-17
Business Address
-- CARLY M PREMO
1 CONWAY CT
TROY, NY 12180-2108
Phone number: 518-274-6525
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Mailing Address
-- CARLY M PREMO
905 3RD AVE
TROY, NY 12182-1918
Phone number: 518-274-6525
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