Individual
SUZANNE WALCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1314 E 54TH ST, BROOKLYN, NY 11234-3344
(718) 444-0854
Mailing address
1314 E 54TH ST, BROOKLYN, NY 11234-3344
(718) 444-0854
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
521537
NY
Other
Enumeration date
06/25/2010
Last updated
06/25/2010
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