SHADY BOURHAM

BROOKLYN, NY
NPI1316480643
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  327253)
Enumeration Date2016-11-18
Last Update Date2016-11-18
Business Address
-- SHADY BOURHAM
6321 NEW UTRECHT AVE
BROOKLYN, NY 11219-5425
Phone number: 212-687-7464
Mailing Address
-- SHADY BOURHAM
250 CENTRAL AVE APT215-B
NEWARK, NJ 07103-4201
Phone number: 203-252-8704
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