Provider Demographics
NPI:1497123178
Name:VEGA, NATALIE ANNE
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:ANNE
Last Name:VEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:NATALIE
Other - Middle Name:ANNE
Other - Last Name:SLATTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:32 METZNER RD
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-2141
Mailing Address - Country:US
Mailing Address - Phone:632-428-8211
Mailing Address - Fax:631-648-0803
Practice Address - Street 1:32 METZNER RD
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-2141
Practice Address - Country:US
Practice Address - Phone:632-428-8211
Practice Address - Fax:631-648-0803
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY276125164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse