Individual
ALTANISE WHICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 RYER AVE, 3RD FLOOR, BRONX, NY 10457-1104
(718) 960-0602
Mailing address
762 CAULDWELL AVE, #1, BRONX, NY 10456-7628
(718) 665-0360
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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