Provider Demographics
NPI:1568611895
Name:NUNEZ, JOSE RAFAEL JR (LPN)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:RAFAEL
Last Name:NUNEZ
Suffix:JR
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 N 15TH ST
Mailing Address - Street 2:SUITE NUMBER 8
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-2048
Mailing Address - Country:US
Mailing Address - Phone:716-373-1749
Mailing Address - Fax:
Practice Address - Street 1:5485 NICHOLS RUN
Practice Address - Street 2:
Practice Address - City:LIMESTONE
Practice Address - State:NY
Practice Address - Zip Code:14753-9774
Practice Address - Country:US
Practice Address - Phone:716-925-8664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261635164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse