Individual
ABIWAQQAS LARYEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
801 E 241ST ST, BRONX, NY 10470-1303
(718) 671-2100
Mailing address
801 E 241ST ST, BRONX, NY 10470-1303
(718) 671-2100
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
747006
NY
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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