Stephen Anthony Henry

Individual provider Active NPI Licensed Practical Nurse · Marlboro, NY

NPI 1326646993 · NPPES record last updated Oct 15, 2020

Key facts

NPI
1326646993
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
332734 (NY)
Practice address
65 South St
Marlboro, NY 12542-6316
Phone
(845) 275-4525
NPI assigned
Oct 15, 2020
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
332734NYMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 332734 NY Yes

Addresses

Primary practice location

65 South St
Marlboro, NY 12542-6316

Mailing address

65 South St
Marlboro, NY 12542-6316

Other providers in Marlboro, NY

All providers in Marlboro, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.