Individual
CARL ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13936 254TH ST, ROSEDALE, NY 11422-2616
(718) 828-2666
Mailing address
89 BARTLETT ST, BROOKLYN, NY 11206-4463
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
329641
NY
Other
Enumeration date
02/02/2023
Last updated
02/02/2023
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