Individual
CORAL INNISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1492 BEDFORD AVE APT 2B, BROOKLYN, NY 11216-3886
(718) 857-4740
(718) 857-4740
Mailing address
1492 BEDFORD AVE APT 2B, BROOKLYN, NY 11216-3886
(718) 857-4740
(718) 857-4740
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
404951031
NY
Other
Enumeration date
07/02/2015
Last updated
07/02/2015
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