Individual
EDITTA M JEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
129 W 147TH ST APT 2G, NEW YORK, NY 10039-4305
(646) 281-9637
Mailing address
129 W 147TH ST APT 2G, NEW YORK, NY 10039-4305
(646) 281-9637
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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