Individual
AVIANN LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
194 MACDOUGAL ST, BROOKLYN, NY 11233-2780
(917) 975-0289
Mailing address
194 MACDOUGAL ST, BROOKLYN, NY 11233-2780
(917) 975-0289
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1248498181
NY
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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