Provider Demographics
NPI:1447561097
Name:ABELLARD, WANYA (LPN)
Entity type:Individual
Prefix:
First Name:WANYA
Middle Name:
Last Name:ABELLARD
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 1:2455 UNION BLVD
Mailing Address - Street 2:APT 1H
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-3116
Mailing Address - Country:US
Mailing Address - Phone:516-830-5978
Mailing Address - Fax:
Practice Address - Street 1:2455 UNION BLVD
Practice Address - Street 2:APT 1H
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3116
Practice Address - Country:US
Practice Address - Phone:516-830-5978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287743251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care