Provider Demographics
NPI:1972801843
Name:ASSELTA, BETH CHRISTINE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:CHRISTINE
Last Name:ASSELTA
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 1:78 ALOMA RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-9599
Mailing Address - Country:US
Mailing Address - Phone:631-767-8489
Mailing Address - Fax:
Practice Address - Street 1:78 ALOMA RD
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-9599
Practice Address - Country:US
Practice Address - Phone:631-767-8489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296997164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse