Individual
BLONDINE LILAVOIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1190 E 40TH ST, BROOKLYN, NY 11210-4426
(917) 603-3078
Mailing address
1190 E 40TH ST, BROOKLYN, NY 11210-4426
(917) 603-3078
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
725030
NY
Other
Enumeration date
02/05/2017
Last updated
02/05/2017
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