Latesha Heron

NPI 1750795399 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1750795399
Gender Female
Enumeration Date 06/11/2014
Last Updated 06/11/2014
Entity Type Individual
Active Over 2 years ago
Practice Location
17728 TROUTVILLE RD
JAMAICA NY, 11434-2712, US
Phone (646) 894-7154
Fax
Business Location
17728 TROUTVILLE RD
JAMAICA NY, 11434-2712, US
Phone
Fax
Toxanomy
Taxonomy Code 164W00000X
License State New York
License Number 313772
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According to our database, Latesha Heron NPI is 1750795399, taxonomy code is 164W00000X and license number is 313772, license state is located at New York. Latesha Heron physically located at 17728 Troutville Rd, Jamaica NY, 11434-2712. NPI Number Latesha Heron has the Individual type.

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1750795399 NPI number is provided on an as is basis without warranty of any kind. 1750795399 is maintained by the National Plan & Provider Enumeration System. The contents of Latesha Heron are for informational purposes only.