Individual
CHAQUANNA SHATIA BOYKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
333 NORTH ST, NEWBURGH, NY 12550-3151
(845) 309-7005
Mailing address
333 NORTH ST, NEWBURGH, NY 12550-3151
(845) 309-7005
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
289508-1
NY
Other
Enumeration date
08/13/2015
Last updated
08/13/2015
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