Individual
COLETTE DWYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11223 203RD ST, SAINT ALBANS, NY 11412-2209
(555) 305-3325
Mailing address
11223 203RD ST, SAINT ALBANS, NY 11412-2209
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
642768
NY
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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