Individual
EVA TRAVIESO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7910 BROADWAY, ELMHURST, NY 11373-1340
(718) 833-4000
Mailing address
3733 76TH ST APT 1C, JACKSON HEIGHTS, NY 11372-6542
(347) 984-1656
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
001363
NY
Other
Enumeration date
12/14/2022
Last updated
12/14/2022
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