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Individual

MR. ANSELM LALLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
1516 ORIENTAL BLVD, BROOKLYN, NY 11235-2328
(718) 646-4441
Mailing address
2775 E 16TH ST APT 6F, BROOKLYN, NY 11235-4060

Taxonomy

Speciality
Code
Description
License number
State
163WC1600X
Continuing Education/Staff Development Registered Nurse
Primary
684194
NY

Other

Enumeration date
11/16/2022
Last updated
11/16/2022
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