Individual
ADELLA J BODDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
961 E 94TH ST, BROOKLYN, NY 11236-2023
(917) 459-8578
Mailing address
961 E 94TH ST, BROOKLYN, NY 11236-2023
(917) 459-8578
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
220299
NY
Other
Enumeration date
02/05/2010
Last updated
02/05/2010
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