Provider Demographics
NPI:1184992992
Name:DEL, BRIDGETTE (LPN)
Entity type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:
Last Name:DEL
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 1:335 LOUIS AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-3524
Mailing Address - Country:US
Mailing Address - Phone:516-967-6349
Mailing Address - Fax:
Practice Address - Street 1:335 LOUIS AVE
Practice Address - Street 2:
Practice Address - City:SOUTH FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-3524
Practice Address - Country:US
Practice Address - Phone:516-967-6349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2960091164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse