Macedonia Olofson, Lisa Marie

Macedonia Olofson, Lisa Marie is an sole proprietor health care provider with primary practice located at 9 Corral Lane , East Northport NY 11731. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Macedonia Olofson, Lisa Marie can be contacted via phone (631) 368-0169.

Contact Information

Primary practice address
9 Corral Lane East Northport NY 11731
Phone: (631) 368-0169
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 415592 New York

Profile Details

NPI number 1851572812
LBN Legal business name Macedonia Olofson, Lisa Marie
Credentials LICENSED REGISTERED
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 19th, 2007
Last updated Nov 19th, 2007 - about 18 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 1851572812 NPPES
New York MEDICAID 02638113

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