Individual
TZIPORA BAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 BROADHOLLOW RD, MELVILLE, NY 11747-4992
(631) 559-7887
Mailing address
58 VALLEY LN W, VALLEY STREAM, NY 11581-3633
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
92958601
NY
Other
Enumeration date
03/08/2024
Last updated
03/08/2024
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