Individual
MIMOSE CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5101 AVENUE M, BROOKLYN, NY 11234-3825
(718) 272-2946
Mailing address
666 E 88TH ST, BROOKLYN, NY 11236-3402
(347) 432-5294
Taxonomy
Speciality
Code
Description
License number
State
363LS0200X
School Nurse Practitioner
Primary
502800-1
NY
Other
Enumeration date
03/22/2023
Last updated
03/22/2023
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