Individual
LATOYA DUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5645 MAIN ST, FLUSHING, NY 11355
(347) 229-4798
Mailing address
5645 MAIN ST, FLUSHING, NY 11355-5045
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
306365
NY
363LG0600X
Gerontology Nurse Practitioner
340891
NY
Other
Enumeration date
12/05/2014
Last updated
07/22/2024
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