Individual
ISADORA N ARIAS TAVAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
590 PARK AVE # 2, YONKERS, NY 10703-1524
(347) 990-4802
Mailing address
590 PARK AVE # 2, YONKERS, NY 10703-1524
(347) 990-4802
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
350009077
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6402676
DOS ID
NY
Enumeration date
12/16/2022
Last updated
12/16/2022
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