Individual
AYESHA N WATTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
985 INTERVALE AVE APT 3B, BRONX, NY 10459-3166
(347) 224-1652
Mailing address
985 INTERVALE AVE APT 3B, BRONX, NY 10459-3166
(347) 224-1652
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
328901-1
NY
Other
Enumeration date
07/31/2017
Last updated
07/31/2017
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