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1104064955
VICTOR MARI JATA
BRONX, NY
NPI
1104064955
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 293982-1)
Enumeration Date
2009-02-02
Last Update Date
2009-02-02
Business Address
-- VICTOR MARI JATA
960 SHERIDAN AVE 5D
BRONX, NY 10456-6301
Phone number: 917-349-5856
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Mailing Address
-- VICTOR MARI JATA
960 SHERIDAN AVE 5D
BRONX, NY 10456-6301
Phone number: 917-349-5856
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