Provider Demographics
NPI:1053694208
Name:LABOY, SOCORRO (LPN)
Entity type:Individual
Prefix:
First Name:SOCORRO
Middle Name:
Last Name:LABOY
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 1:207 HALLOCK RD.
Mailing Address - Street 2:ST.201
Mailing Address - City:STONYBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-3073
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:207 HALLOCK RD.
Practice Address - Street 2:ST.201
Practice Address - City:STONYBROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-3073
Practice Address - Country:US
Practice Address - Phone:631-689-8920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232586-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse