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1235433160
DAPHNEY BOURJOLLY
CENTRAL ISLIP, NY
NPI
1235433160
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Former Name
DAPHNEY BOURJOLLY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 304080)
Enumeration Date
2011-01-06
Last Update Date
2011-01-06
Business Address
-- DAPHNEY BOURJOLLY Daphney Bourjolly
125 HAWTHORNE AVE 346
CENTRAL ISLIP, NY 11722-1367
Phone number: 631-327-6969
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Mailing Address
-- DAPHNEY BOURJOLLY Daphney Bourjolly
125 HAWTHORNE AVE 346
CENTRAL ISLIP, NY 11722-1367
Phone number: 631-327-6969
Copy
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