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NPI 1003135344

NPI 1003135344 : GERNITE HENRY : UNIONDALE, NY

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General NPI Number Information
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    NPI Number           |    1003135344
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    Entity Type          |    Individual 
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    Provider Name        |    GERNITE HENRY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/26/2010
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    Last Update Date     |    05/26/2010
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Provider Practice Location Address
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    Address Line         |    680 CAMPUS ST 
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    City                 |    UNIONDALE
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    State                |    NY
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    Zip                  |    11553-2907
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    Country              |    US
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    Telephone            |    516-292-3783
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    680 CAMPUS ST 
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    City                 |    UNIONDALE
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    State                |    NY
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    Zip                  |    11553-2907
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    Country              |    US
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    Telephone            |    516-292-3783
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    164W00000X
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    Taxonomy Name        |    Licensed Practical Nurse
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    License Number       |    295346
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    License Number State |    NY
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