Provider Demographics
NPI:1245593128
Name:FILION, MANDY M (LPN)
Entity Type:Individual
Prefix:MS
First Name:MANDY
Middle Name:M
Last Name:FILION
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 1:20 CARPENTER ST
Mailing Address - Street 2:
Mailing Address - City:ELLENBURG CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:12934-1940
Mailing Address - Country:US
Mailing Address - Phone:518-521-7476
Mailing Address - Fax:
Practice Address - Street 1:20 CARPENTER ST
Practice Address - Street 2:
Practice Address - City:ELLENBURG CENTER
Practice Address - State:NY
Practice Address - Zip Code:12934-1940
Practice Address - Country:US
Practice Address - Phone:518-521-7476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-16
Last Update Date:2012-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302615-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse