Individual
ASIA FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3490 JEFFERSON RIDGE DR APT 307, JEFFERSONVILLE, IN 47130-7326
(646) 515-5130
Mailing address
3490 JEFFERSON RIDGE DR APT 307, JEFFERSONVILLE, IN 47130-7326
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/28/2025
Last updated
08/28/2025
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