Individual
USFORD SERRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1443 E 54TH ST, BROOKLYN, NY 11234-3305
(347) 558-8448
(347) 554-8791
Mailing address
1443 E 54TH ST, BROOKLYN, NY 11234-3305
(347) 558-8448
(347) 554-8791
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
T63185833
VA
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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