Doctor Name: | LOUISE LYDIA REID |
NPI Number: | 1104197995 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 607032-1 |
Business Practice Address: | 57 Peters Blvd Central Islip, NY - 117223654 |
Business Phone Number: | 6313655811 |
Business Fax Number: | |
Mailing Address: | 57 Peters Blvd, CENTRAL ISLIP |
State: | NY |
Postal Code: | 117223654 |
Phone Number: | 6313655811 |
Fax Number: | |
NPI Enumeration Date: | 01/25/2012 |
NPI Last Update Date: | 01/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | 607032-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |