Individual
BASMATTIE UDITSUKHU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8798 193RD ST, HOLLIS, NY 11423-1439
(646) 670-1876
Mailing address
8798 193RD ST, HOLLIS, NY 11423-1439
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
668061-1
NY
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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