Individual
BRITTANIE J ETIENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2240
Mailing address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
032305
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032305
NEW YORK STATE EDUCATION DEPARTMENT OFFICE OF PROFESSIONS
NY
Enumeration date
07/08/2024
Last updated
09/13/2024
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