Registry details
Type
Individual
Primary specialty
Internal Medicine, Hematology
Enumerated
Jun 13, 2012
License(s)
125060838 (IL), 036137955 (IL), 036137955 (IL), 300746 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 161 FORT WASHINGTON AVE | New York, NY 10032-3729 | 212-305-5098 |
| MAILING | 630 W 168TH ST # 4 | New York, NY 10032-3725 | 212-305-5098 |
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