Provider Demographics
NPI:1437544707
Name:FRAZILE, JUNIE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:JUNIE
Middle Name:
Last Name:FRAZILE
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 1:833 BAUER ST
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4316
Mailing Address - Country:US
Mailing Address - Phone:516-451-2880
Mailing Address - Fax:
Practice Address - Street 1:833 BAUER ST
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4316
Practice Address - Country:US
Practice Address - Phone:516-451-2887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY314806-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse