Individual
TEYLO AKIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17 RATHBUN AVE, STATEN ISLAND, NY 10312-3002
(646) 250-0574
Mailing address
17 RATHBUN AVE, STATEN ISLAND, NY 10312-3002
(646) 250-0574
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
6037641
NY
Other
Enumeration date
07/07/2010
Last updated
07/29/2022
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