Individual
MRS. KIEWANDA SHABAZZ-HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
432 BERGEN ST, HARRISON, NJ 07029-2291
(973) 493-5336
Mailing address
432 BERGEN ST, HARRISON, NJ 07029-2291
(973) 483-5336
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
26NO11517600
NY
Other
Enumeration date
06/29/2021
Last updated
06/29/2021
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