Individual
BEVERLEY WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
241 GOTHAM AVE, ELMONT, NY 11003-2105
(718) 926-0766
Mailing address
241 GOTHAM AVE, ELMONT, NY 11003-2105
(718) 926-0766
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
274586
NY
Other
Enumeration date
12/10/2009
Last updated
07/14/2014
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