Individual
AYASHA HOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
958 E 85TH ST, BROOKLYN, NY 11236-3804
(347) 552-3268
Mailing address
958 E 85TH ST, BROOKLYN, NY 11236-3804
(347) 552-3268
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
316135
NY
Other
Enumeration date
07/05/2016
Last updated
07/05/2016
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