Organization
HOME CARE NURSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL BIANCA GAYLE (LPN)
(646) 707-9830
Entity
Organization
Contact information
Practice address
4416 MONTICELLO AVE, BRONX, NY 10466
(646) 707-9830
Mailing address
4416 MONTICELLO AVE, BRONX, NY 10466-1138
(646) 707-9830
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
2906851
NY
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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