Individual
CLARA VELMA HAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4528 40TH AVE, 2R, SUNNYSIDE, NY 11104
(347) 417-1245
Mailing address
4528 40TH ST, SUNNYSIDE, NY 11104-3942
(347) 417-1245
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
329438
NY
Other
Enumeration date
09/20/2017
Last updated
07/21/2022
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