Individual
GEETHA AJAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12915 150TH AVE, SOUTH OZONE PARK, NY 11420-4211
(718) 529-8720
Mailing address
12915 150TH AVE, SOUTH OZONE PARK, NY 11420-4211
(718) 529-8720
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
558176
NY
Other
Enumeration date
03/21/2012
Last updated
03/21/2012
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