Individual
AYANNA ISHEKA DEWAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24146 86TH AVE, BELLEROSE, NY 11426-1251
(347) 260-8220
Mailing address
24146 86TH AVE, BELLEROSE, NY 11426-1251
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
320608
NY
Other
Enumeration date
06/20/2017
Last updated
06/20/2017
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