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Individual

AIYANNA SPELLMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
429 E 148TH ST, BRONX, NY 10455-4128
(757) 582-4925
Mailing address
429 E 148TH ST, BRONX, NY 10455-4128

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
12/29/2018
Last updated
12/29/2018
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