Individual
TAVION NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2811 QUEENS PLZ N, LONG ISLAND CITY, NY 11101-4172
(718) 391-8300
Mailing address
23 BARONE DR, CORAM, NY 11727-3082
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
886047
NY
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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