Individual
MARY HELEN AKHUEMOKHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27 WARREN ST, BRENTWOOD, NY 11717-1530
(631) 617-5808
Mailing address
27 WARREN ST, BRENTWOOD, NY 11717-1530
(631) 617-5808
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
511985
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163W00000X
—
NY
Enumeration date
02/03/2017
Last updated
02/03/2017
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