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Mary Diane Kalkhof, LPN

Licensed Practical Nurse in Medford, NY. Individual provider (NPI-1).

NPI number1699080606
StatusActive
Last updated in NPPESAug 13, 2010

Details

NPI
1699080606
Entity type
Individual (NPI-1)
Name
Mrs. Mary Diane Kalkhof
Credential
LPN
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 13, 2010
Last updated
Aug 13, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
164W00000X Licensed Practical Nurse237551-1NYYes

Other names

  • Mary Diane Kalkhof (Former Name)

Practice location

5 Russell Ct
Medford, NY 11763-4013

Phone 631-475-7831

Mailing address

5 Russell Ct
Medford, NY 11763-4013

Phone 631-475-7831

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