Individual
DAVIE BISSOONDATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
89 BARTLETT ST, BROOKLYN, NY 11206-4463
(718) 828-2666
Mailing address
6 MOUNT AVE, FREEPORT, NY 11520-2826
(347) 581-1377
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
335443
NY
Other
Enumeration date
07/06/2019
Last updated
07/06/2019
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