ALPHONSO RUSS

DEER PARK, NY
NPI1316178957
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  295557)
Enumeration Date2009-07-30
Last Update Date2009-07-30
Business Address
Mr. ALPHONSO RUSS L.P.N
11 W 14TH ST
DEER PARK, NY 11729-4019
Phone number: 631-404-0413
Mailing Address
Mr. ALPHONSO RUSS L.P.N
11 W 14TH ST
DEER PARK, NY 11729-4019
Phone number: 631-404-0413
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