Provider Demographics
NPI:1497172860
Name:SANON, PASCALE (LPN)
Entity Type:Individual
Prefix:
First Name:PASCALE
Middle Name:
Last Name:SANON
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 1:370 E 31ST ST APT 4I
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-7931
Mailing Address - Country:US
Mailing Address - Phone:917-676-8574
Mailing Address - Fax:
Practice Address - Street 1:370 E 31ST ST APT 4I
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-7931
Practice Address - Country:US
Practice Address - Phone:917-676-8574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292042164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse