Sara Rose Lake LPN

NPI 1487800751 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1487800751
Gender Female
Enumeration Date 08/18/2008
Last Updated 08/18/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
111 PORT WATSON ST
CORTLAND NY, 13045-3157, US
Phone (607) 753-9326
Fax
Business Location
111 PORT WATSON ST
CORTLAND NY, 13045-3157, US
Phone (607) 753-9326
Fax
Toxanomy
Taxonomy Code 164W00000X
License State New York
License Number 282607-1
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According to our database, Sara Rose Lake LPN NPI is 1487800751, taxonomy code is 164W00000X and license number is 282607-1, license state is located at New York. Sara Rose Lake LPN physically located at 111 Port Watson St, Cortland NY, 13045-3157. NPI Number Sara Rose Lake LPN has the Individual type.

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1487800751 NPI number is provided on an as is basis without warranty of any kind. 1487800751 is maintained by the National Plan & Provider Enumeration System. The contents of Sara Rose Lake LPN are for informational purposes only.