Ports, Wendy Carol

Ports, Wendy Carol is an individual health care provider with primary practice located at 243 W End Ave , Shirley NY 11967-1606. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Ports, Wendy Carol can be contacted via phone (631) 772-4871.

Contact Information

Primary practice address
243 W End Ave Shirley NY 11967-1606
Phone: (631) 772-4871
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 00269213 New York

Profile Details

NPI number 1134328271
LBN Legal business name Ports, Wendy Carol
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2007
Last updated Jul 17th, 2007 - about 17 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 1134328271 NPPES
New York MEDICAID 02670675

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