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Individual

AVIS HAREWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NT

Contact information

Practice address
2534 STEINWAY ST, ASTORIA, NY 11103-3702
(718) 777-5243
(718) 777-5250
Mailing address
415 E 54TH ST, BROOKLYN, NY 11203-4646
(718) 922-3944

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
004153-1
NY

Other

Enumeration date
11/19/2007
Last updated
11/19/2007
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