Individual
MISS UFETA TESLA OM'INIABOHS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITONER
Contact information
Practice address
295 FLATBUSH AVENUE EXT, BROOKLYN, NY 11201-3001
(718) 522-1144
Mailing address
970 E 81ST ST, BROOKLYN, NY 11236-3840
(347) 581-5257
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F421331-1
NY
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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