Individual
MISS LAURIN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9114 MERRICK BLVD, JAMAICA, NY 11432-5363
(718) 408-7178
Mailing address
9114 MERRICK BLVD, JAMAICA, NY 11432-5363
(718) 408-7178
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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