Provider Demographics
NPI:1043755622
Name:ALBERT, LUDNER
Entity Type:Individual
Prefix:
First Name:LUDNER
Middle Name:
Last Name:ALBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 COMMUNITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:MANHASST
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2518
Mailing Address - Country:US
Mailing Address - Phone:516-323-7737
Mailing Address - Fax:
Practice Address - Street 1:330 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3816
Practice Address - Country:US
Practice Address - Phone:516-323-7737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296987164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse