Most Relevant Information
Provider Data
| NPI Number: | 1003474495 |
| Provider Name: | QUANEISHA BOONE BA |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/31/2019 |
| Last Updated: | 11/04/2021 |
Provider Practice Location
2369 2ND AVE
NEW YORK
NY
100353108
Practice Location Phone/Fax
| Phone: | 2128762300 |
| Fax: | 2127227618 |
Provider Mailing Location
2369 2ND AVE
NEW YORK
NY
100353108
Provider Mailing Phone/Fax
| Phone: | 2128762300 |
| Fax: | 2127227618 |