Wolleta Blackwood

NPI #1356196752 in Elmont, New York

Provider Information

NPI Number: 1356196752
Entity Type: Individual
Name: Wolleta Blackwood
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Registered Nurse
Enumeration Date: Apr 19, 2024
Last Updated: Apr 21, 2024

Practice Location

Address: 1944 JACKSON AVE
City: Elmont
State: New York
ZIP Code: 11003-4200
Phone: (516) 424-0169

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary

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