Individual
LEELAMMA V KOIKKAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N
Contact information
Practice address
2324 FOREST AVE, STATEN ISLAND, NY 10303-1506
(718) 447-0200
(718) 981-1431
Mailing address
175 WESTWOOD AVE, STATEN ISLAND, NY 10314-5414
(718) 494-6258
(718) 981-1431
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
304062
NY
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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