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General NPI Number Information
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NPI Number | 1780077164
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Entity Type | Organization
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Legal Business Name | LISA ARCANGEL
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Dates
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Enumeration Date | 03/10/2015
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 56 GREENFIELD AVE
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City | WEST SENECA
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State | NY
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Zip | 14224-1407
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Country | US
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Telephone | 716-997-6203
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Fax |
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Provider Business Mailing Address
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Address Line | 56 GREENFIELD AVE
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City | WEST SENECA
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State | NY
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Zip | 14224-1407
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Country | US
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Telephone | 716-997-6203
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Fax |
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Authorized Official
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Title or Position | REGISTERD NURSE
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Name | MISS LISA ARCANGEL
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Credential | RN
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Telephone | 716-997-6203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 6168261
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License Number State | NY
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