Individual
EARLENA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2015 GRAND AVE APT 2F, BRONX, NY 10453-4576
(718) 299-7285
Mailing address
1434 WILLIAMSBRIDGE RD FL 2, BRONX, NY 10461-2507
(718) 618-0401
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
F30996-01
NY
Other
Enumeration date
12/10/2020
Last updated
03/19/2021
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