Pennant, Melissa

Pennant, Melissa is an sole proprietor health care provider with primary practice located at 189 Beech St , Valley Stream NY 11580-4903. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Pennant, Melissa can be contacted via phone (718) 809-9685.

Contact Information

Primary practice address
189 Beech St Valley Stream NY 11580-4903
Phone: (718) 809-9685
Fax: (718) 228-7059
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 298786 New York

Profile Details

NPI number 1043532864
LBN Legal business name Pennant, Melissa
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 20th, 2010
Last updated Nov 10th, 2022 - about 2 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 1043532864 NPPES
New York MEDICAID 06335780

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