Provider Demographics
NPI:1437782604
Name:MALDONADO, PIERANGELIE (LPN)
Entity Type:Individual
Prefix:
First Name:PIERANGELIE
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:PIERANGELIE
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140 BOND STREET
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704
Mailing Address - Country:US
Mailing Address - Phone:646-251-7757
Mailing Address - Fax:
Practice Address - Street 1:140 BOND STREET
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704
Practice Address - Country:US
Practice Address - Phone:646-251-7757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333764-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse