Individual
AISHA Z. FORMENTERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
700 LENOX AVE APT 11E, NEW YORK, NY 10039-4530
(347) 282-3251
Mailing address
700 LENOX AVE APT 11E, NEW YORK, NY 10039-4530
(347) 282-3251
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
790579
NY
Other
Enumeration date
06/03/2020
Last updated
06/03/2020
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