Individual
MS. KENNY MIKITA LACOSSIERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 717-3028
(212) 717-3118
Mailing address
60 TURNER PL, APT 5W, BROOKLYN, NY 11218-3447
(718) 469-4618
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
304963-1
NY
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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