Individual
DAVIDA HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICENSED PRACTICAL N
Contact information
Practice address
937 FULTON ST, BROOKLYN, NY 11238-2347
(718) 789-1212
(718) 789-3045
Mailing address
937 FULTON ST, BROOKLYN, NY 11238-2347
(718) 789-1212
(718) 789-3045
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
258916
NY
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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