Provider Demographics
NPI:1699925511
Name:CETRANGOL, CHRISTINE (LPN)
Entity type:Individual
Prefix:MISS
First Name:CHRISTINE
Middle Name:
Last Name:CETRANGOL
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 1:2 ALICE LN
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3103
Mailing Address - Country:US
Mailing Address - Phone:631-942-8721
Mailing Address - Fax:
Practice Address - Street 1:2 ALICE LN
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3103
Practice Address - Country:US
Practice Address - Phone:631-942-8721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-27
Last Update Date:2008-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2853654164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse