Provider Demographics
NPI:1881842532
Name:MAYO, PAULETTE LEE (RN)
Entity Type:Individual
Prefix:MS
First Name:PAULETTE
Middle Name:LEE
Last Name:MAYO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-3038
Mailing Address - Country:US
Mailing Address - Phone:716-681-3323
Mailing Address - Fax:
Practice Address - Street 1:147 4TH AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NY
Practice Address - Zip Code:14086-3038
Practice Address - Country:US
Practice Address - Phone:716-681-3323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-07
Last Update Date:2008-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY455629-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse