JOHNNY GERVAIS

BRENTWOOD, NY
NPI1881986784
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  304534-1)
Enumeration Date2011-05-10
Last Update Date2011-05-10
Business Address
-- JOHNNY GERVAIS LPN
216 GRAND BLVD
BRENTWOOD, NY 11717-5913
Phone number: 516-348-4317
Mailing Address
-- JOHNNY GERVAIS LPN
216 GRAND BLVD
BRENTWOOD, NY 11717-5913
Phone number: 516-348-4317