Individual
CHEVINE JODIAN CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
250 UTICA AVE, BROOKLYN, NY 11213-3931
(718) 953-9012
(866) 495-5854
Mailing address
765 E 228TH ST, BRONX, NY 10466-4211
(347) 634-0642
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0947589
NY
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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