Individual
AISHA WALCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
489 BAINBRIDGE ST, BASEMENT, BROOKLYN, NY 11233-2010
(347) 529-7088
Mailing address
489 BAINBRIDGE ST, BASEMENT, BROOKLYN, NY 11233-2010
(347) 529-7088
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
300243
NY
Other
Enumeration date
03/23/2010
Last updated
05/21/2010
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