Individual
MR. RONISH KUTTIKATTILJOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7925 WINCHESTER BLVD, QUEENS VILLAGE, NY 11427-2128
(718) 264-4000
Mailing address
7925 WINCHESTER BLVD, QUEENS VILLAGE, NY 11427-2128
(718) 264-4000
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
708041
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50150
—
NY
Enumeration date
02/05/2018
Last updated
02/05/2018
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