Provider Demographics
NPI:1801471073
Name:VALIDO, CONRADO MACAPAGAL JR (LPN)
Entity type:Individual
Prefix:
First Name:CONRADO
Middle Name:MACAPAGAL
Last Name:VALIDO
Suffix:JR
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 NEWPORT GAP PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-6179
Mailing Address - Country:US
Mailing Address - Phone:860-514-8346
Mailing Address - Fax:860-924-4559
Practice Address - Street 1:1812 NEWPORT GAP PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-6179
Practice Address - Country:US
Practice Address - Phone:302-500-5910
Practice Address - Fax:302-500-5872
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-10
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN95244164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse