Individual
MANDISA HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
511 CLEVELAND ST, BROOKLYN, NY 11208-2119
(917) 957-0648
Mailing address
511 CLEVELAND ST, BROOKLYN, NY 11208-2119
(917) 957-0648
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
666542
NY
163WS0200X
School Registered Nurse
Primary
666542
NY
Other
Enumeration date
03/28/2016
Last updated
04/11/2016
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