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1205276813
TRACY ALEXIS JADE LARRY
NEW YORK, NY
NPI
1205276813
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2013-06-27
Last Update Date
2013-06-27
Business Address
Miss TRACY ALEXIS JADE LARRY
34 W 139TH ST
NEW YORK, NY 10037-1508
Phone number: 212-690-7234
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Mailing Address
Miss TRACY ALEXIS JADE LARRY
500 W 148TH ST #5C
NEW YORK, NY 10031-4107
Phone number: 917-602-0100
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