Individual
EBONI J JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14431 226TH ST, LAURELTON, NY 11413-3533
(917) 288-9954
Mailing address
14431 226TH ST, LAURELTON, NY 11413-3533
(917) 288-9954
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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