Johnson Exantus, LPN | |
60 Crown St, Deer Park, NY 11729-6921 | |
(631) 392-0199 | |
Not Available |
Full Name | Johnson Exantus |
---|---|
Gender | Male |
Speciality | Licensed Practical Nurse |
Location | 60 Crown St, Deer Park, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073890729 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
164W00000X | Licensed Practical Nurse | 301511 (New York) | Primary |
Mailing Address | Practice Location Address |
---|---|
Johnson Exantus, LPN 60 Crown St, Deer Park, NY 11729-6921 Ph: (631) 392-0199 | Johnson Exantus, LPN 60 Crown St, Deer Park, NY 11729-6921 Ph: (631) 392-0199 |
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