Individual
ADIE IMANI EMILY EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10569 AVENUE K, BROOKLYN, NY 11236-3017
(848) 223-9361
Mailing address
10569 AVENUE K, BROOKLYN, NY 11236-3017
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
328980
NY
Other
Enumeration date
11/17/2017
Last updated
11/17/2017
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