Individual
MISS MARCELLE JANICE WILLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
664 E 81ST ST, BROOKLYN, NY 11236-3304
(917) 579-3575
Mailing address
664 E 81ST ST, BROOKLYN, NY 11236-3304
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F3085231
NY
Other
Enumeration date
11/27/2017
Last updated
10/27/2020
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