Individual
MISS DEMETRIC BOWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
814 CROSS BAY BLVD, BROAD CHANNEL, NY 11693-1126
(718) 717-4759
Mailing address
814 CROSS BAY BLVD, BROAD CHANNEL, NY 11693-1126
(718) 717-4759
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CRPAP9314
NY
Other
Enumeration date
12/10/2025
Last updated
01/09/2026
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