Provider Demographics
NPI:1871729319
Name:JALIL, TRASY LYNN (LPN)
Entity type:Individual
Prefix:
First Name:TRASY
Middle Name:LYNN
Last Name:JALIL
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 1:70 HILL COURT CIR
Mailing Address - Street 2:APT E
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-1195
Mailing Address - Country:US
Mailing Address - Phone:585-290-6072
Mailing Address - Fax:
Practice Address - Street 1:70 HILL COURT CIR
Practice Address - Street 2:APT E
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1195
Practice Address - Country:US
Practice Address - Phone:585-290-6072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296325-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse