Individual
EDI PEGUERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
149 ETNA ST, APT 1, BROOKLYN, NY 11208-1362
(347) 240-2272
Mailing address
149 ETNA ST, APT 1, BROOKLYN, NY 11208-1362
(347) 240-2272
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
5811471
NY
Other
Enumeration date
07/07/2010
Last updated
07/07/2010
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