Individual
MS. KIMBERLEY S ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6500
(212) 241-5544
Mailing address
285 E 34TH ST, BROOKLYN, NY 11203-3801
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
F304768-1
NY
Other
Enumeration date
03/21/2008
Last updated
07/10/2011
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