Individual
BERNICE BANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
801 E 241ST ST, BRONX, NY 10470-1303
(718) 671-2100
Mailing address
37 HARPER CT, BRONX, NY 10466-6058
(718) 419-9577
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
295282
NY
Other
Enumeration date
07/12/2017
Last updated
07/12/2017
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