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1780098392
CASSANDRA PROVILUS
BROOKLYN, NY
NPI
1780098392
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 309088-1)
Enumeration Date
2014-06-12
Last Update Date
2014-06-12
Business Address
Miss CASSANDRA PROVILUS LPN
450 E 26TH ST PH
BROOKLYN, NY 11226-7711
Phone number: 347-469-5018
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Mailing Address
Miss CASSANDRA PROVILUS LPN
450 E 26TH ST PH
BROOKLYN, NY 11226-7711
Phone number: 347-469-5018
Copy
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