Individual
ASHANTI BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
790 PARK AVE, HUNTINGTON, NY 11743-4516
(631) 470-6788
Mailing address
790 PARK AVE, HUNTINGTON, NY 11743-4516
(631) 470-6788
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
333784
NY
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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