Individual
LATOYA BUCKNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
13436 246TH ST, ROSEDALE, NY 11422-1445
(917) 283-8536
Mailing address
13436 246TH ST, ROSEDALE, NY 11422-1445
(917) 283-8536
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F308989-1
NY
Other
Enumeration date
02/12/2019
Last updated
02/12/2019
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