Individual
BETINA BOLIERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7403 COMMONWEALTH BLVD, BELLEROSE, NY 11426-1839
(718) 264-4500
Mailing address
7403 COMMONWEALTH BLVD, BELLEROSE, NY 11426-1839
(718) 264-4500
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
610131
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
610131
—
NY
Enumeration date
11/01/2019
Last updated
11/01/2019
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