Individual
ANDREA DEVARIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3555 OXFORD AVE, BRONX, NY 10463-1718
(718) 601-2613
Mailing address
PO BOX 1112, BRONX, NY 10471-0600
(718) 601-2613
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
884946
NY
Other
Enumeration date
05/29/2015
Last updated
08/12/2015
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