Individual
BELLA DAVARASHVILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22121 JAMAICA AVE, QUEENS VILLAGE, NY 11428-2015
(718) 468-6923
Mailing address
22121 JAMAICA AVE, QUEENS VILLAGE, NY 11428-2015
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
276389
NY
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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