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1881986784
JOHNNY GERVAIS
BRENTWOOD, NY
NPI
1881986784
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 304534-1)
Enumeration Date
2011-05-10
Last Update Date
2011-05-10
Business Address
-- JOHNNY GERVAIS LPN
216 GRAND BLVD
BRENTWOOD, NY 11717-5913
Phone number: 516-348-4317
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Mailing Address
-- JOHNNY GERVAIS LPN
216 GRAND BLVD
BRENTWOOD, NY 11717-5913
Phone number: 516-348-4317
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