Provider Demographics
NPI:1558726612
Name:BETHEL, ALENE (LPN)
Entity Type:Individual
Prefix:
First Name:ALENE
Middle Name:
Last Name:BETHEL
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 1:35 W 33RD ST
Mailing Address - Street 2:APT 8D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3310
Mailing Address - Country:US
Mailing Address - Phone:212-629-4494
Mailing Address - Fax:
Practice Address - Street 1:35 W 33RD ST
Practice Address - Street 2:APT 8D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3311
Practice Address - Country:US
Practice Address - Phone:212-629-4494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278867164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse