Individual
ATHELINE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16937 144TH RD, JAMAICA, NY 11434-5929
(718) 978-7221
Mailing address
1467 E 102ND ST, BROOKLYN, NY 11236-5509
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
268959
NY
Other
Enumeration date
06/11/2011
Last updated
06/11/2011
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