Individual
KNIKA MAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1511 AVALON PINES DR, CORAM, NY 11727-5140
(718) 974-9626
Mailing address
1511 AVALON PINES DR, CORAM, NY 11727-5140
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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