Individual
CHLOE ROSE KOUTRAS HIWOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
18 ELIAS PL, STATEN ISLAND, NY 10314-2303
(718) 619-0679
Mailing address
18 ELIAS PL, STATEN ISLAND, NY 10314-2303
(718) 619-0679
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
342080
NY
Other
Enumeration date
06/07/2024
Last updated
06/07/2024
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