Susan Tina Waldt LPN

NPI 1417103771 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1417103771
Gender Female
Enumeration Date 08/18/2008
Last Updated 08/18/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
512 ROSEWOOD ROAD
SYRACUSE NY, 13209, US
Phone (315) 491-0181
Fax
Business Location
512 ROSEWOOD ROAD
SYRACUSE NY, 13209, US
Phone (315) 491-0181
Fax
Toxanomy
Taxonomy Code 164W00000X
License State New York
License Number 270162-1
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According to our database, Susan Tina Waldt LPN NPI is 1417103771, taxonomy code is 164W00000X and license number is 270162-1, license state is located at New York. Susan Tina Waldt LPN physically located at 512 Rosewood Road, Syracuse NY, 13209. NPI Number Susan Tina Waldt LPN has the Individual type.

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1417103771 NPI number is provided on an as is basis without warranty of any kind. 1417103771 is maintained by the National Plan & Provider Enumeration System. The contents of Susan Tina Waldt LPN are for informational purposes only.