ILLEKUTTIGE FERNANDO

STATEN ISLAND, NY
NPI1518518687
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy163W00000X Registered Nurse
(Licence: NY  777629)
Enumeration Date2019-09-20
Last Update Date2019-09-20
Business Address
ILLEKUTTIGE FERNANDO
26 DUMONT AVE
STATEN ISLAND, NY 10305-1450
Phone number: 718-667-8510
Mailing Address
ILLEKUTTIGE FERNANDO
128 CASTLETON AVE
STATEN ISLAND, NY 10301-3004
Phone number:
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