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1295338739
JUSTINE IVAN
POUGHKEEPSIE, NY
NPI
1295338739
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 30775901)
Enumeration Date
2020-11-18
Last Update Date
2020-11-18
Business Address
JUSTINE IVAN
15 BOBRICK RD
POUGHKEEPSIE, NY 12601-5107
Phone number: 718-510-2058
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Mailing Address
JUSTINE IVAN
15 BOBRICK RD
POUGHKEEPSIE, NY 12601-5107
Phone number:
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