Individual
MYRENE ANGELINE ROQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 WATERS PL, BRONX, NY 10461-2723
(929) 348-3464
Mailing address
1542 MAC DONOUGH PL, BRONX, NY 10465-1130
(646) 409-7673
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
785234
NY
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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