Individual
NALLELIS CAROLINA PERALTA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
85 W BURNSIDE AVE, BRONX, NY 10453-4015
(718) 716-4400
Mailing address
855 COURTLANDT AVE APT 310, BRONX, NY 10451-4958
(646) 417-4003
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
031247
NY
Other
Enumeration date
05/12/2021
Last updated
05/12/2021
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