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General NPI Number Information
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NPI Number | 1205208048
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Entity Type | Individual
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Provider Name | KATHLEEN HELEN HERRERA R.N
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Gender | Female
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 10/20/2015
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Provider Practice Location Address
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Address Line | 27 BADGER RD
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City | MANORVILLE
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State | NY
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Zip | 11949-3201
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Country | US
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Telephone | 631-909-4379
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Fax | 631-909-4379
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Provider Business Mailing Address
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Address Line | 27 BADGER RD
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City | MANORVILLE
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State | NY
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Zip | 11949-3201
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Country | US
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Telephone | 631-909-4379
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Fax | 631-909-4379
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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 | 146D00000X
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Taxonomy Name | Personal Emergency Response Attendant
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License Number | 577916-1
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License Number State | NY
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