Individual
AUSTIN SOUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
191 JORALEMON ST, BROOKLYN, NY 11201-4306
(718) 722-6000
Mailing address
191 JORALEMON ST, BROOKLYN, NY 11201-4306
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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