Provider Demographics
NPI:1770845604
Name:PAUL, AL. (LPN)
Entity Type:Individual
Prefix:MR
First Name:AL.
Middle Name:
Last Name:PAUL
Suffix:
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 1:447 CLARENDON RD
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-2105
Mailing Address - Country:US
Mailing Address - Phone:516-860-7901
Mailing Address - Fax:
Practice Address - Street 1:130-20 89TH RD
Practice Address - Street 2:
Practice Address - City:RICHMOND HILLS
Practice Address - State:NY
Practice Address - Zip Code:11418
Practice Address - Country:US
Practice Address - Phone:718-441-8913
Practice Address - Fax:718-846-9064
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233033164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse