Individual
COLLEEN JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10583 SEAVIEW AVE, BROOKLYN, NY 11236-4625
(718) 763-5370
Mailing address
10583 SEAVIEW AVE, BROOKLYN, NY 11236-4625
(718) 763-5370
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
274527
NY
Other
Enumeration date
12/10/2010
Last updated
12/10/2010
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