MICHAEL KENNETH TAX

PORT JEFFERSON, NY
NPI1790244317
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  262016-1)
Enumeration Date2019-03-13
Last Update Date2019-03-13
Business Address
MICHAEL KENNETH TAX lpn
125 OAKLAND AVE STE 204
PORT JEFFERSON, NY 11777-2130
Phone number: 631-686-1414
Mailing Address
MICHAEL KENNETH TAX lpn
1206 BROADWAY AVE
HOLBROOK, NY 11741-5413
Phone number: 631-295-7701
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