Individual
WANDA K SKOCZYLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
782 E 17TH ST, BROOKLYN, NY 11230-2413
(917) 225-2001
Mailing address
782 E 17TH ST, BROOKLYN, NY 11230-2413
(917) 225-2001
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
013287
NY
Other
Enumeration date
08/25/2009
Last updated
08/25/2009
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