Individual
ASSITA GNANGADOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1388 BUSHWICK AVE, BROOKLYN, NY 11207-1870
(347) 335-8551
Mailing address
1388 BUSHWICK AVE, BROOKLYN, NY 11207-1870
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
725868
NY
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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