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Individual

MRS. ANNI T THADAVILA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N., B.S.N.

Contact information

Practice address
699 92ND ST, BROOKLYN, NY 11228-3619
(718) 567-1234
Mailing address
15 HAY ST, STATEN ISLAND, NY 10304-4464
(718) 720-3949

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
451559-1
NY

Other

Enumeration date
03/25/2007
Last updated
07/08/2007
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