Individual
KEISHA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7229 BERGEN CT APT 1, BROOKLYN, NY 11234-5820
(718) 926-6088
Mailing address
7229 BERGEN CT APT 1, BROOKLYN, NY 11234-5820
(718) 926-6088
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F307667-1
NY
Other
Enumeration date
03/24/2017
Last updated
03/24/2017
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