Individual
AHJALEE XENOBIA RICHARD716
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26 DUMONT AVE, STATEN ISLAND, NY 10305-1450
(718) 667-8511
Mailing address
345 THATFORD AVE APT 5R, BROOKLYN, NY 11212-5969
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1652004
NY
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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