Individual
DEVORAH BOROUMAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1498 E 4TH ST, BROOKLYN, NY 11230-6333
(347) 856-8768
Mailing address
1498 E 4TH ST, BROOKLYN, NY 11230-6333
(718) 951-4955
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
725044
NY
363LF0000X
Family Nurse Practitioner
Primary
352941
NY
Other
Enumeration date
01/12/2022
Last updated
11/17/2023
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