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MARK BENGOUGH
>> Licensed Practical Nurse >> Nursing Service ProvidersRegistrant NPI Number: 1659706356
Individual Registrant: MARK BENGOUGH
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
2701 ROUTE 12B DEANSBORO, NY 13328 US
Tel: 315-797-1115 Fax: --
Tel: 315-797-1115 Fax: --
Contact information for business:
2701 ROUTE 12B DEANSBORO, NY 13328 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1659706356
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 164W00000X | Nursing Service Providers Licensed Practical Nurse | NY | 7597567 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
