Provider Demographics
NPI:1346487501
Name:VARGAS, DEBBIE LORENA
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:LORENA
Last Name:VARGAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 SPRUCEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-3838
Mailing Address - Country:US
Mailing Address - Phone:516-992-0628
Mailing Address - Fax:
Practice Address - Street 1:168 SPRUCEWOOD DR
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-3838
Practice Address - Country:US
Practice Address - Phone:516-992-0628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292725164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse