Individual
MS. BOUTICHA YVONNE MOUZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
804 E 138TH ST, BRONX, NY 10454-1902
(718) 665-7500
Mailing address
804 E 138TH ST, BRONX, NY 10454-1902
(718) 665-7500
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
267113
NY
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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