Provider Demographics
NPI:1922338201
Name:HAKOUN, TINA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:
Last Name:HAKOUN
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 1:421 SPROUT BROOK RD.
Mailing Address - Street 2:
Mailing Address - City:GARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10524
Mailing Address - Country:US
Mailing Address - Phone:845-736-4050
Mailing Address - Fax:
Practice Address - Street 1:421 SPROUT BROOK RD
Practice Address - Street 2:
Practice Address - City:GARRISON
Practice Address - State:NY
Practice Address - Zip Code:10524-7405
Practice Address - Country:US
Practice Address - Phone:845-736-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251969163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse