Individual
MRS. PON IDA BENNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
2601 OCEAN PARKWAY, BROOKLYN, NY 11235-1123
(718) 616-3991
Mailing address
67 MANHATTAN CT APT B, BROOKLYN, NY 11235-6205
(718) 616-3991
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
406734
NY
Other
Enumeration date
09/12/2017
Last updated
09/12/2017
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