Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Aug 18, 2021
License(s)
348169 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 52 MAXWELL RD | Garden City, NY 11530-1847 | |
| LOCATION | 805 NORTHERN BLVD | Great Neck, NY 11021-5301 | 516-614-1160 |
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