Individual
MISS BROOKE ROXANNE RAVENEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
500 8TH AVE, 3RD FLOOR, NEW YORK, NY 10018-6504
(212) 904-1500
Mailing address
4024 LACONIA AVE, APT. #1A, BRONX, NY 10466-4921
(347) 697-7419
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
225751-1
NY
Other
Enumeration date
12/30/2010
Last updated
12/30/2010
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