Provider Demographics
NPI:1225338163
Name:CARBY, LATOYA (LPN)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:
Last Name:CARBY
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 1:19239 HOLLIS AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2832
Mailing Address - Country:US
Mailing Address - Phone:910-554-5860
Mailing Address - Fax:718-413-7052
Practice Address - Street 1:19239 HOLLIS AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2832
Practice Address - Country:US
Practice Address - Phone:910-554-5860
Practice Address - Fax:718-413-7052
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296880164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse