Healthcare Provider Details

I. General information

NPI: 1881994630
Provider Name (Legal Business Name): LENIE Y. LLAMAS RN- BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 10/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2478 JERUSALEM AVE
NORTH BELLMORE NY
11710
US

IV. Provider business mailing address

48 FRANCINE AVE.
MASSAPEQUA NY
11758
US

V. Phone/Fax

Practice location:
  • Phone: 516-826-1160
  • Fax:
Mailing address:
  • Phone: 631-498-4421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number468377-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: