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1164917977
LISSA HERIVEAUX
BROOKLYN, NY
NPI
1164917977
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 330844)
Enumeration Date
2018-06-25
Last Update Date
2018-06-25
Business Address
LISSA HERIVEAUX
6321 NEW UTRECHT AVE
BROOKLYN, NY 11219-5425
Phone number: 212-687-7464
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Mailing Address
LISSA HERIVEAUX
6321 NEW UTRECHT AVE
BROOKLYN, NY 11219-5425
Phone number: 212-687-7464
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