Provider Demographics
NPI:1689864696
Name:FLIEDNER, EMILY MOIRA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:MOIRA
Last Name:FLIEDNER
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 1:60 BONNIE LN
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2543
Mailing Address - Country:US
Mailing Address - Phone:631-546-5703
Mailing Address - Fax:
Practice Address - Street 1:60 BONNIE LN
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2543
Practice Address - Country:US
Practice Address - Phone:631-546-5703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288849164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse