Individual
NATHALIE AVIGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
97-77 QUEENS BLVD, PENTHOUSE, REGO PARK, NY 11374
(718) 896-9090
Mailing address
97-77 QUEENS BLVD, PENTHOUSE, REGO PARK, NY 11374
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402272
NY
Other
Enumeration date
08/21/2017
Last updated
08/21/2017
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