Individual
DELVIA I MOQUETE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
54 WEST BURNSIDE AVE, BRONX, NY 10453-4018
(718) 299-5454
Mailing address
3215 TENBROECK AVE, BRONX, NY 10469-5010
(347) 964-6707
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
008560
NY
Other
Enumeration date
12/05/2007
Last updated
12/05/2007
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