Provider Demographics
NPI:1437333598
Name:CARTER, RAYMOND LEVESTER (LPN)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:LEVESTER
Last Name:CARTER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 22ND ST
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-2319
Mailing Address - Country:US
Mailing Address - Phone:716-285-7168
Mailing Address - Fax:
Practice Address - Street 1:559 22ND ST
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-2319
Practice Address - Country:US
Practice Address - Phone:716-285-7168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190457-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse