Individual
ANGELINE PUNZAL TOTARAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26 DUMONT AVE, STATEN ISLAND, NY 10305-1450
(718) 667-8510
Mailing address
32 SELVIN LOOP, STATEN ISLAND, NY 10303-1745
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
334702
NY
Other
Enumeration date
05/09/2019
Last updated
05/09/2019
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