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Individual

MISITURA A EJIOYE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
121 LAKE ST, BROOKLYN, NY 11223-2734
(718) 645-6454
Mailing address
1351 BROOKLYN AVE APT 5C, BROOKLYN, NY 11203-5562
(347) 433-9635

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
794382-01
NY

Other

Enumeration date
09/20/2021
Last updated
09/20/2021
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