Individual
MRS. AUTUMN UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
165 PARKWAY BLVD, WYANDANCH, NY 11798-4305
(917) 415-0157
Mailing address
165 PARKWAY BLVD, WYANDANCH, NY 11798-4305
(917) 415-0157
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
544384
NY
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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