Individual
MISS CORY ALLYSON JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
317 NORTH ST, WHITE PLAINS, NY 10605-2209
(917) 597-4062
(914) 597-4004
Mailing address
410 BENEDICT AVE, 5E, TARRYTOWN, NY 10591-4939
(860) 539-7696
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
660768
NY
Other
Enumeration date
05/24/2013
Last updated
05/24/2013
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