Individual
ANDRA TILLERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2811 QUEENS PLZ N, LONG ISLAND CITY, NY 11101-4172
(718) 391-8300
Mailing address
9524 SCHENCK ST APT 3, BROOKLYN, NY 11236-5576
(347) 320-8017
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
810841
NY
163WS0200X
School Registered Nurse
Primary
810841
NY
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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