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TAIRU TRERRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1296 SHERIDAN AVE APT 3I, BRONX, NY 10456-1399
(646) 546-1431
Mailing address
1296 SHERIDAN AVE APT 3I, BRONX, NY 10456-1399
(646) 546-1431

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
318466
NY

Other

Enumeration date
05/22/2014
Last updated
05/22/2014
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