Individual
DESIANNE NATANYA FRASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
1822 STILLWELL AVE, FRONT DESK, BRONX, NY 10469-1233
(718) 652-7939
Mailing address
745 E 242ND ST APT 2C, BRONX, NY 10470-1233
(914) 406-2817
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
666082-1
NY
Other
Enumeration date
03/24/2014
Last updated
03/24/2014
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