Provider Demographics
NPI:1518108802
Name:DUMAS, YOLETTE (LPN)
Entity Type:Individual
Prefix:
First Name:YOLETTE
Middle Name:
Last Name:DUMAS
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 1:145 W 19TH ST
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-4833
Mailing Address - Country:US
Mailing Address - Phone:631-940-1066
Mailing Address - Fax:631-940-1066
Practice Address - Street 1:145 W 19TH ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-4833
Practice Address - Country:US
Practice Address - Phone:631-940-1066
Practice Address - Fax:631-940-1066
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296387164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse