Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Jun 2, 2008
License(s)
F335376 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2015 GRAND CONCOURSE | Bronx, NY 10453-4303 | 718-299-7295 |
| MAILING | 1434 WILLIAMSBRIDGE RD FL 2 | Bronx, NY 10461-2507 | 718-618-0401 |
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