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1801371786
PETER JOEL BLACKBURNE
VALLEY STREAM, NY
NPI
1801371786
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
163WP0808X Registered Nurse, Psych/Mental Health
(Licence: NY 535252)
Enumeration Date
2018-09-26
Last Update Date
2018-10-10
Business Address
PETER JOEL BLACKBURNE RN
3 JEFFERSON AVE
VALLEY STREAM, NY 11580-2925
Phone number: 718-775-1200
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Mailing Address
PETER JOEL BLACKBURNE RN
3 JEFFERSON AVE
VALLEY STREAM, NY 11580-2925
Phone number: 718-775-1200
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