Individual
AIDA DAVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
34 W 139TH ST, NEW YORK, NY 10037-1508
(212) 632-4532
Mailing address
17 PINE LN, VALLEY STREAM, NY 11581-2601
(516) 603-2843
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
231640201
NY
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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