Individual
MRS. TETLA M ROQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
122 E 23RD ST, NEW YORK, NY 10010-4516
(212) 677-7400
Mailing address
3315 HONE AVE, BRONX, NY 10469-3709
(718) 515-5560
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
296438-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
296438-1
REGISTERED NURSE
NY
Enumeration date
01/16/2007
Last updated
07/08/2007
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