Antonova, Michele G.

Antonova, Michele G. is an individual health care provider with primary practice located at 2308 Quarrystone Ln , Middle Island NY 11953-1478. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Antonova, Michele G. can be contacted via phone (631) 365-1462.

Contact Information

Primary practice address
2308 Quarrystone Ln Middle Island NY 11953-1478
Phone: (631) 365-1462
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 626949-1 New York

Profile Details

NPI number 1518287127
LBN Legal business name Antonova, Michele G.
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2010
Last updated Jun 4th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518287127 NPPES
New York MEDICAID 626949-1

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