Petula Anesia Anderson REGISTERED NURSE

NPI 1093109209 - Registered Nurse - 163W00000X

NPI Details
NPI 1093109209
Gender Female
Enumeration Date 03/25/2015
Last Updated 03/25/2015
Entity Type Individual
Active Over 1 year ago
Practice Location
20 JERUSALEM AVE
3RD FLOOR
HICKSVILLE NY, 11801-4980, US
Phone (516) 326-2020
Fax (516) 719-7373
Business Location
350 EMPIRE BLVD APT 2C
BROOKLYN NY, 11225-3252, US
Phone (347) 417-6346
Fax
Toxanomy
Taxonomy Code 163W00000X
License State New York
License Number 695171
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According to our database, Mrs. Petula Anesia Anderson REGISTERED NURSE NPI is 1093109209, taxonomy code is 163W00000X and license number is 695171, license state is located at New York. Petula Anesia Anderson REGISTERED NURSE physically located at 20 Jerusalem Ave, Hicksville NY, 11801-4980. NPI Number Petula Anesia Anderson REGISTERED NURSE has the Individual type.

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1093109209 NPI number is provided on an as is basis without warranty of any kind. 1093109209 is maintained by the National Plan & Provider Enumeration System. The contents of Petula Anesia Anderson REGISTERED NURSE are for informational purposes only.