Provider Demographics
NPI:1255593471
Name:BARTHOLOMEW, DARVON SCHNELL (LPN)
Entity type:Individual
Prefix:MRS
First Name:DARVON
Middle Name:SCHNELL
Last Name:BARTHOLOMEW
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 1:66 SCHNEIDER LN
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-4337
Mailing Address - Country:US
Mailing Address - Phone:631-630-1644
Mailing Address - Fax:
Practice Address - Street 1:66 SCHNEIDER LN
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-4337
Practice Address - Country:US
Practice Address - Phone:631-630-1644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-29
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238084-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse