Individual
AUDREY IDDRISU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
398 BROAD AVE # 393, LEONIA, NJ 07605-1618
(917) 865-7600
Mailing address
398 BROAD AVE # 393, LEONIA, NJ 07605-1618
(551) 999-7751
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
02/09/2023
Last updated
02/09/2023
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