Individual
LISA PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
965 E 56TH ST, BROOKLYN, NY 11234-1703
(718) 531-8379
Mailing address
965 E 56TH ST, BROOKLYN, NY 11234-1703
(718) 531-8379
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
4793031
NY
Other
Enumeration date
07/01/2010
Last updated
07/01/2010
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