Individual
JANNELLY NIEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
87 COLUMBIA STREET APT 14F, NEW YORK, NY 10002
(917) 583-7461
Mailing address
87 COLUMBIA ST APT 14F, NEW YORK, NY 10002-1913
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
135941
NY
Other
Enumeration date
06/07/2017
Last updated
06/07/2017
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