Individual
HUSSUHAN NOMBRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
515 AUDUBON AVE, NEW YORK, NY 10040-3403
(646) 288-0147
Mailing address
1310 SHERIDAN AVE APT 6K, BRONX, NY 10456-1397
(646) 288-0147
Taxonomy
Speciality
Code
Description
License number
State
163WR0400X
Rehabilitation Registered Nurse
Primary
N28380
NY
Other
Enumeration date
05/25/2026
Last updated
05/25/2026
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