Individual
SHANNEN-CZARINA BALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1983 MARCUS AVE STE E100E110, NEW HYDE PARK, NY 11042-2000
(516) 497-7600
Mailing address
74 CEDAR SWAMP RD APT 2, GLEN COVE, NY 11542-4376
(516) 851-0956
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
821878-01
NY
Other
Enumeration date
06/21/2024
Last updated
06/21/2024
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