Individual
CORA INNIS-MASCOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7 PAERDEGAT 13TH ST, BROOKLYN, NY 11236-4121
(718) 241-6641
Mailing address
7 PAERDEGAT 13TH ST, BROOKLYN, NY 11236-4121
(718) 241-6641
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
2199671
NY
Other
Enumeration date
06/29/2010
Last updated
06/29/2010
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