Individual
ALA ROH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20305 32ND AVE, BAYSIDE, NY 11361-1021
(718) 939-6137
Mailing address
20305 32ND AVE, BAYSIDE, NY 11361-1021
(718) 939-6137
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/29/2020
Last updated
06/29/2020
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