Provider Demographics
NPI:1982961546
Name:ARROYO, REBCCA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:REBCCA
Middle Name:
Last Name:ARROYO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 W LAKELAND ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-2621
Mailing Address - Country:US
Mailing Address - Phone:631-243-0962
Mailing Address - Fax:
Practice Address - Street 1:1095 JOSELSON AVE
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-2035
Practice Address - Country:US
Practice Address - Phone:631-434-2260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY388060163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool