Provider Demographics
NPI:1831740745
Name:MOMPOINT, GUILENE (LPN)
Entity type:Individual
Prefix:
First Name:GUILENE
Middle Name:
Last Name:MOMPOINT
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:PO BOX 528094
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11352-8094
Mailing Address - Country:US
Mailing Address - Phone:516-787-4778
Mailing Address - Fax:
Practice Address - Street 1:218-66-99 AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429-8094
Practice Address - Country:US
Practice Address - Phone:516-787-4778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334452164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse