Individual
DAVINA TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1271 BROOKLYN AVE, BROOKLYN, NY 11203-5550
(347) 385-6962
Mailing address
1271 BROOKLYN AVE, BROOKLYN, NY 11203-5550
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
265634
NY
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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