Individual
AYESHA-NERISSA EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1240 E 40TH ST, BROOKLYN, NY 11210-4923
(347) 276-2596
Mailing address
1240 E 40TH ST, BROOKLYN, NY 11210-4923
(347) 276-2596
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/13/2019
Last updated
09/13/2019
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