Most Relevant Information
Provider Data
| NPI Number: | 1003332560 |
| Provider Name: | MAX FAUBERT LYSIUS LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 328684 |
Most Important Dates
| Enumeration Date: | 08/16/2017 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
6303 YULEWOOD CIR
CICERO
NY
130399251
Practice Location Phone/Fax
| Phone: | 3158850550 |
| Fax: |
Provider Mailing Location
6303 YULEWOOD CIR
CICERO
NY
130399251
Provider Mailing Phone/Fax
| Phone: | 3158850550 |
| Fax: |