Individual
MISS DAISHA HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22121 JAMAICA AVE, QUEENS VILLAGE, NY 11428-2015
(718) 468-6923
(718) 468-6925
Mailing address
22121 JAMAICA AVE, QUEENS VILLAGE, NY 11428-2015
(718) 468-6923
(718) 468-6925
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
296357
NY
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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