Individual
AYANNA VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
51 SILVER ST, ELMONT, NY 11003-3622
(347) 935-4942
Mailing address
51 SILVER ST, ELMONT, NY 11003-3622
(347) 935-4942
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
855549
NY
164W00000X
Licensed Practical Nurse
906323
NY
Other
Enumeration date
10/04/2019
Last updated
12/23/2025
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