Individual
BRIGITTE IWANICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
134 BEACH 123RD ST, ROCKAWAY PARK, NY 11694-1838
(646) 512-3423
Mailing address
134 BEACH 123RD ST, ROCKAWAY PARK, NY 11694-1838
(646) 512-3423
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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