Provider Demographics
NPI:1801225602
Name:VARGAS, SOLANGE (LPN)
Entity Type:Individual
Prefix:
First Name:SOLANGE
Middle Name:
Last Name:VARGAS
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 1:8910 35TH AVE APT C5R
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-5734
Mailing Address - Country:US
Mailing Address - Phone:718-639-7819
Mailing Address - Fax:
Practice Address - Street 1:8910 35TH AVE APT C5R
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-5734
Practice Address - Country:US
Practice Address - Phone:718-639-7819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291921164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse