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General NPI Number Information
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NPI Number | 1467584243
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Entity Type | Individual
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Provider Name | AUDREY S. KHADRAOUI LPN
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 04/16/2013
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Provider Practice Location Address
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Address Line | 501 FRANKLIN AVENUE SUITE 301
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City | GARDEN CITY
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State | NY
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Zip | 11530
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Country | US
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Telephone | 631-782-7150
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Fax |
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Provider Business Mailing Address
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Address Line | 501 FRANKLIN AVENUE SUITE 301
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City | GARDEN CITY
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State | NY
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Zip | 11530
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Country | US
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Telephone | 516-782-7150
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Fax | 516-307-5808
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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 | 267514
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License Number State | NY
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