Individual
MS. JEANNE PROSPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27 WEST 69TH STREET, SUITE A, NEW YORK, NY 10023-4740
(212) 579-0914
Mailing address
27 WEST 69TH STREET, SUITE A, NEW YORK, NY 10023-4740
(212) 579-0914
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00342443
—
NY
Enumeration date
10/22/2007
Last updated
10/22/2007
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