Individual
MS. ANTIONETTE KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26 DUMONT AVE, STATEN ISLAND, NY 10305-1450
(718) 667-8510
Mailing address
806 HENDERSON AVENUE APARTMENT 1C, STATEN ISLAND, NY 10310
(347) 475-5915
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
329373-1
NY
Other
Enumeration date
02/06/2018
Last updated
02/06/2018
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