Provider Demographics
NPI:1588867089
Name:SILNE-ALLONCE, MANUELLA (LPN)
Entity type:Individual
Prefix:
First Name:MANUELLA
Middle Name:
Last Name:SILNE-ALLONCE
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 1:329 W JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5322
Mailing Address - Country:US
Mailing Address - Phone:516-812-7614
Mailing Address - Fax:
Practice Address - Street 1:329 W JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5322
Practice Address - Country:US
Practice Address - Phone:516-812-7614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY265009164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02730725Medicaid