| Doctor Name: | CAROL HENCK |
| NPI Number: | 1275803694 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 2738991 |
| Business Practice Address: | 322 Lagoon Dr W Lido Beach, NY - 115614908 |
| Business Phone Number: | 5168972070 |
| Business Fax Number: | 5167713999 |
| Mailing Address: | 322 Lagoon Dr W, LIDO BEACH |
| State: | NY |
| Postal Code: | 115614908 |
| Phone Number: | 5168972070 |
| Fax Number: | 5167713999 |
| NPI Enumeration Date: | 01/02/2012 |
| NPI Last Update Date: | 01/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 2738991 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |