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1174020580
ABIWAQQAS LARYEA
BRONX, NY
NPI
1174020580
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: NY 747006)
Enumeration Date
2018-04-11
Last Update Date
2018-04-11
Business Address
ABIWAQQAS LARYEA
801 E 241ST ST
BRONX, NY 10470-1303
Phone number: 718-671-2100
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Mailing Address
ABIWAQQAS LARYEA
801 E 241ST ST
BRONX, NY 10470-1303
Phone number: 718-671-2100
Copy
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