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General NPI Number Information
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NPI Number | 1831976000
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Entity Type | Individual
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Provider Name | MISS HEATHER LYNN NEALE
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Gender | Female
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 7464 WATER ST
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City | MADISON
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State | NY
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Zip | 13402-9507
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Country | US
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Telephone | 315-750-8167
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Fax |
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Provider Business Mailing Address
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Address Line | 7464 WATER ST
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City | MADISON
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State | NY
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Zip | 13402-9507
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Country | US
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Telephone | 315-750-8167
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 00758341
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License Number State | NY
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