Individual
ATHALIA BALLESTEROS BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8268 164TH ST # 1B-02, JAMAICA, NY 11432-1121
(718) 883-3070
(718) 883-6115
Mailing address
8268 164TH ST # 1B-02, JAMAICA, NY 11432-1121
(718) 883-3070
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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