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1285104760
CHANTAY WALLACE
NEW YORK, NY
NPI
1285104760
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 766721987)
Enumeration Date
2018-11-28
Last Update Date
2018-11-28
Business Address
CHANTAY WALLACE
142 W 143RD ST APT 3A
NEW YORK, NY 10030-1665
Phone number: 917-916-2216
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Mailing Address
CHANTAY WALLACE
142 W 143RD ST APT 3A
NEW YORK, NY 10030-1665
Phone number: 917-916-2216
Copy
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