Individual
DESIREE AVIANCE HOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 METROTECH, 29 TH FLOOR, BROOKLYN, NY 11201
(718) 422-4200
Mailing address
830 ASHFORD ST APT 7G, BROOKLYN, NY 11207-8108
(347) 848-9626
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
790821
NY
Other
Enumeration date
04/15/2022
Last updated
04/19/2022
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