Provider Demographics
NPI:1710189378
Name:BARTOLI, ALZENA ZANOBIA (LPN)
Entity Type:Individual
Prefix:
First Name:ALZENA
Middle Name:ZANOBIA
Last Name:BARTOLI
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 1:29 BITTERMINT ST
Mailing Address - Street 2:
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-2801
Mailing Address - Country:US
Mailing Address - Phone:631-664-0414
Mailing Address - Fax:
Practice Address - Street 1:29 BITTERMINT ST
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-2801
Practice Address - Country:US
Practice Address - Phone:631-664-0414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2551241164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse