Provider Demographics
NPI:1164731659
Name:PFAFF, ANN-MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:ANN-MARIE
Middle Name:
Last Name:PFAFF
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22121 JAMAICA AVE
Mailing Address - Street 2:2 FLOOR
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-2015
Mailing Address - Country:US
Mailing Address - Phone:718-468-6923
Mailing Address - Fax:718-468-6925
Practice Address - Street 1:22121 JAMAICA AVE
Practice Address - Street 2:2 FLOOR
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428-2015
Practice Address - Country:US
Practice Address - Phone:718-468-6923
Practice Address - Fax:718-468-6925
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271751164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse