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1528698065
LENNY DOMINIQUE
BAYSIDE, NY
NPI
1528698065
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 336167-01)
Enumeration Date
2020-01-23
Last Update Date
2020-01-23
Business Address
LENNY DOMINIQUE LPN
22215 NORTHERN BLVD
BAYSIDE, NY 11361-3678
Phone number: 718-225-1414
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Mailing Address
LENNY DOMINIQUE LPN
1964 NOSTRAND AVE APT 1E
BROOKLYN, NY 11210-1504
Phone number: 347-420-8196
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