Provider Demographics
NPI:1144676461
Name:ANDINO VALDEZ, LYNN CARMEN (LPN)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:CARMEN
Last Name:ANDINO VALDEZ
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 1:2232 POWELL AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-5104
Mailing Address - Country:US
Mailing Address - Phone:347-703-7362
Mailing Address - Fax:
Practice Address - Street 1:2232 POWELL AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-5104
Practice Address - Country:US
Practice Address - Phone:347-703-7362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308133164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse