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1972048791
LACEY DOUGLAS
NEW YORK, NY
NPI
1972048791
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: NY 723183)
Enumeration Date
2017-01-03
Last Update Date
2017-01-03
Business Address
LACEY DOUGLAS
110 W 97TH ST
NEW YORK, NY 10025-6450
Phone number: 212-748-1820
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Mailing Address
LACEY DOUGLAS
42 PAERDEGAT 5TH ST
BROOKLYN, NY 11236-4138
Phone number:
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