Individual
ALICE EDUVIGES WEISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
767 E 169TH ST, BRONX, NY 10456-2609
(718) 378-0800
(718) 378-0801
Mailing address
767 E 169TH ST, BRONX, NY 10456-2609
(718) 378-0800
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
03/20/2018
Last updated
03/20/2018
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