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General NPI Number Information
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NPI Number | 1114335486
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Entity Type | Organization
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Legal Business Name | YOLANDA MICHINSKI
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Dates
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Enumeration Date | 07/30/2014
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Last Update Date | 07/30/2014
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Provider Practice Location Address
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Address Line | 150 MARCY ST
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City | WEST BABYLON
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State | NY
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Zip | 11704-3402
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Country | US
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Telephone | 631-539-6083
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Fax | 631-539-6083
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Provider Business Mailing Address
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Address Line | 150 MARCY ST
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City | WEST BABYLON
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State | NY
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Zip | 11704-3402
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Country | US
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Telephone | 631-539-6083
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Fax | 631-539-6083
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Authorized Official
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Title or Position | LPN
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Name | MS. YOLANDA MICHINSKI
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Credential |
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Telephone | 631-539-6083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 10149091
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License Number State | NY
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