Individual
BEVERLY WILLIAMS VALLEJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23835 148TH DR, ROSEDALE, NY 11422-3246
(347) 994-4103
Mailing address
23835 148TH DR, ROSEDALE, NY 11422-3246
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
695313-1
NY
Other
Enumeration date
04/01/2015
Last updated
04/01/2015
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