Provider Demographics
NPI:1972986222
Name:ARNOLD, TAYLOR (LPN)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:ARNOLD
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 1:447 ST PAULS AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2147
Mailing Address - Country:US
Mailing Address - Phone:718-608-5984
Mailing Address - Fax:
Practice Address - Street 1:201 CUBA AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-4701
Practice Address - Country:US
Practice Address - Phone:718-608-5984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-06
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310791164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse