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1922320738
KETTLY ST SURIN
QUEENS VILLAGE, NY
NPI
1922320738
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 215736)
Enumeration Date
2010-02-20
Last Update Date
2016-10-31
Business Address
-- KETTLY ST SURIN LPN
22121 JAMAICA AVE
QUEENS VILLAGE, NY 11428-2015
Phone number: 917-882-3745
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Mailing Address
-- KETTLY ST SURIN LPN
22121 JAMAICA AVE
QUEENS VILLAGE, NY 11428-2015
Phone number:
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