Individual
MRS. CLARISSA LUZ ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1176 HOE AVE, BRONX, NY 10459-1915
(646) 260-9836
Mailing address
1176 HOE AVE, BRONX, NY 10459-1915
(646) 260-9836
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
312204-1
NY
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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