Individual
CARLENE RHODEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11558 155TH ST, JAMAICA, NY 11434-1528
(347) 592-9429
Mailing address
11558 155TH ST, JAMAICA, NY 11434-1528
(347) 592-9429
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124330634
ACHIEVE BEYOND
NY
Enumeration date
06/15/2022
Last updated
06/15/2022
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