Individual
ANTONNETTE MONIQUE MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3583 WILSON AVE # 1, BRONX, NY 10469-2348
(347) 301-5363
Mailing address
3583 WILSON AVE # 1, BRONX, NY 10469-2348
(347) 301-5363
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
327412
NY
Other
Enumeration date
02/27/2019
Last updated
02/27/2019
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