Provider Demographics
NPI:1164693214
Name:ANDONIAN LPN SERVICES, PC
Entity Type:Organization
Organization Name:ANDONIAN LPN SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ANDONIAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:585-889-0529
Mailing Address - Street 1:2 GATEWAY ROAD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624
Mailing Address - Country:US
Mailing Address - Phone:585-889-0529
Mailing Address - Fax:585-889-0529
Practice Address - Street 1:2 GATEWAY ROAD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-4417
Practice Address - Country:US
Practice Address - Phone:585-889-0529
Practice Address - Fax:585-889-0529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty