Individual
COLETTE AGATHA WELCH-MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1835 ANTHONY AVE, BRONX, NY 10457-5906
(718) 828-2666
Mailing address
1835 ANTHONY AVE, BRONX, NY 10457-5906
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
324452
NY
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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