Individual
PHAEDRA SIRJU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18619 122ND AVE, SPRINGFIELD GARDENS, NY 11413-1074
(917) 254-1398
Mailing address
18619 122ND AVE, SPRINGFIELD GARDENS, NY 11413-1074
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
374J00000X
Doula
Primary
—
—
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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