Individual
CARISSMA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
85 BARTLETT ST, BROOKLYN, NY 11206-4429
(866) 387-8100
Mailing address
85 BARTLETT ST, BROOKLYN, NY 11206-4429
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
313954-1
NY
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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