Most Relevant Information
Provider Data
| NPI Number: | 1003479973 |
| Provider Name: | JESSICA FONSECA- YANCHA LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 328053 |
Most Important Dates
| Enumeration Date: | 04/17/2019 |
| Last Updated: | 04/17/2019 |
Provider Practice Location
1372 MADISON ST
BROOKLYN
NY
112375909
Practice Location Phone/Fax
| Phone: | 7188282666 |
| Fax: |
Provider Mailing Location
1372 MADISON ST
BROOKLYN
NY
112375909
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |