Provider Demographics
NPI:1710233408
Name:STONE, ELIZABETH VICTORIA (LPN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:VICTORIA
Last Name:STONE
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 1:300 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE KATRINE
Mailing Address - State:NY
Mailing Address - Zip Code:12449-5340
Mailing Address - Country:US
Mailing Address - Phone:845-336-3500
Mailing Address - Fax:
Practice Address - Street 1:300 GRANT AVE
Practice Address - Street 2:
Practice Address - City:LAKE KATRINE
Practice Address - State:NY
Practice Address - Zip Code:12449-5340
Practice Address - Country:US
Practice Address - Phone:845-336-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292343164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse