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Individual

AMMAN LIAQAT MIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
143 YORK AVE, STATEN ISLAND, NY 10301-1358
(347) 608-5796
Mailing address
143 YORK AVE, STATEN ISLAND, NY 10301-1358
(347) 608-5796

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
332503
NY

Other

Enumeration date
11/10/2019
Last updated
11/10/2019
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