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1255914263
DEDRA D JOSEPH
VALLEY STREAM, NY
NPI
1255914263
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 280219-1)
Enumeration Date
2021-04-28
Last Update Date
2021-04-28
Business Address
DEDRA D JOSEPH LPN
50 W HAWTHORNE AVE FL 2
VALLEY STREAM, NY 11580-6223
Phone number: 516-204-1320
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Mailing Address
DEDRA D JOSEPH LPN
62 LINCOLN ST
ELMONT, NY 11003-2322
Phone number: 516-412-1240
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