Individual
JANELLE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8268 164TH ST, JAMAICA, NY 11432-1121
(718) 883-4640
Mailing address
25505 149TH RD, ROSEDALE, NY 11422-2814
(678) 733-0926
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
P73130
NY
Other
Enumeration date
09/29/2009
Last updated
09/29/2009
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