Individual
SELISIA JERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
521 BEACH 72ND ST APT 2, ARVERNE, NY 11692-1128
(347) 592-0938
Mailing address
521 BEACH 72ND ST APT 2, ARVERNE, NY 11692-1128
(347) 592-0938
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
661307
NY
Other
Enumeration date
09/19/2012
Last updated
09/19/2012
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