Provider Demographics
NPI:1326273087
Name:SMALL, ALMA MAE (LPN)
Entity Type:Individual
Prefix:MS
First Name:ALMA
Middle Name:MAE
Last Name:SMALL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 EAST GATE BLVD
Mailing Address - Street 2:SUITE 101B
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530
Mailing Address - Country:US
Mailing Address - Phone:516-741-8600
Mailing Address - Fax:516-408-3111
Practice Address - Street 1:825 EAST GATE BLVD
Practice Address - Street 2:SUITE 101B
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-741-8600
Practice Address - Fax:516-408-3111
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY256745164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse