Provider Demographics
NPI:1437571338
Name:REDHEAD, AUBREY (LPN)
Entity Type:Individual
Prefix:MR
First Name:AUBREY
Middle Name:
Last Name:REDHEAD
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 1:4010 FARRAGUT RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2008
Mailing Address - Country:US
Mailing Address - Phone:973-393-8493
Mailing Address - Fax:
Practice Address - Street 1:4010 FARRAGUT RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2008
Practice Address - Country:US
Practice Address - Phone:973-393-8493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308209164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse