Individual
AISHA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11309 208TH ST, QUEENS VILLAGE, NY 11429-2207
(347) 884-3575
Mailing address
11309 208TH ST, QUEENS VILLAGE, NY 11429-2207
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
330353
NY
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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