Provider Demographics
NPI:1427247105
Name:LEHAYAN-LOQUELLANO, AMARYLLIS AMOROSO
Entity type:Individual
Prefix:
First Name:AMARYLLIS
Middle Name:AMOROSO
Last Name:LEHAYAN-LOQUELLANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:AMOROSO
Other - Last Name:LEHAYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:51 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-1929
Mailing Address - Country:US
Mailing Address - Phone:732-234-3004
Mailing Address - Fax:
Practice Address - Street 1:51 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:SAYREVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08872-1929
Practice Address - Country:US
Practice Address - Phone:732-234-3004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR07590900163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse