Individual
ROYELLA BOSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1114 NEW YORK AVE, APT 1F, BROOKLYN, NY 11203-4957
(718) 913-0549
Mailing address
1114 NEW YORK AVE, APT 1F, BROOKLYN, NY 11203-4957
(718) 913-0549
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2717891
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
630204907
METRO PLUS
—
Enumeration date
02/02/2017
Last updated
02/02/2017
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