Individual
MRS. NICOLE EXANTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
649 E 78TH ST, BROOKLYN, NY 11236-3307
(718) 241-2730
Mailing address
649 E 78TH ST, BROOKLYN, NY 11236-3307
(718) 241-2730
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
539285-1
NY
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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