Individual
CHINASA OKON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13 THOMAS AVE, FISHKILL, NY 12524-1106
(845) 546-1375
Mailing address
13 THOMAS AVE, FISHKILL, NY 12524-1106
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
334735
NY
Other
Enumeration date
08/11/2023
Last updated
08/11/2023
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