Organization · Type 2 NPI
Breona Petteway Support Services Incorporated
Licensed Practical Nurse · Wyandanch, NY
Practice location
18 Lake Dr
Wyandanch, NY 11798-3430
Fax (934) 256-2441
Mailing address
54 State St Ste 80416264
Albany, NY 12207-2540
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Licensed Practical Nurse Primary | 164W00000X | None listed |
Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
About NPI 1194674622
Breona Petteway Support Services Incorporated's National Provider Identifier is 1194674622, issued on Jan 27, 2026. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Wyandanch, NY. The record was last updated on Jan 27, 2026.