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Individual

BYRON LEGARDYE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPRA

Contact information

Practice address
1169 RIVER AVE APT 801, BRONX, NY 10452-8494
(718) 964-8613
Mailing address
1169 RIVER AVE APT 801, BRONX, NY 10452-8494
(718) 964-8613

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CPRA6163
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CPRA6163
NY
Enumeration date
05/13/2024
Last updated
05/13/2024
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