Individual
ALICIA CHARISSE DEBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1075 BROADWAY, PLEASANTVILLE, NY 10570-2346
(914) 741-4541
Mailing address
125 RADFORD ST APT 4C, YONKERS, NY 10705-3015
(914) 351-8848
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
316858-01
NY
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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