Individual
MISS CORINA MARY ANN BROUDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN, BA
Contact information
Practice address
98 E 237TH ST, BRONX, NY 10470-1906
(347) 249-4832
Mailing address
98 EAST 237TH STREET, BRONX, NY 10470
(347) 249-4832
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
254629-1
NY
Other
Enumeration date
01/22/2010
Last updated
01/22/2010
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