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1649604190
JILLIAN ALEXA RAE PERALTA
CORAM, NY
NPI
1649604190
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 315188)
Enumeration Date
2013-09-01
Last Update Date
2013-09-01
Business Address
Ms. JILLIAN ALEXA RAE PERALTA LPN
48 FEDERAL LN
CORAM, NY 11727-1618
Phone number: 646-596-6128
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Mailing Address
Ms. JILLIAN ALEXA RAE PERALTA LPN
48 FEDERAL LN
CORAM, NY 11727-1618
Phone number: 646-596-6128
Copy
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