MEDICARE: MS. ALEXANDREA DROFENIK LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	10322238	NY

General Provider Information

NPI Number	:	1467822890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALEXANDREA DROFENIK LPN

Provider Business Mailing Address
First Line	:	857 S OYSTER BAY RD
Second Line	:
City	:	BETHPAGE
State	:	NY
Zip	:	11714-1030
Country	:	US
Telephone Number	:	631-433-1059
Fax Number	:	631-775-8219

Provider Business Practice Location Address
First Line	:	857 SOUTH OYSTER BAY ROAD
Second Line	:
City	:	BETHPAGE
State	:	NY
Zip	:	11714-1661
Country	:	US
Telephone Number	:	631-433-1059
Fax Number	:	631-775-8219

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2015
Last Update Date	:	12/29/2015

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