Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Mar 23, 2018
License(s)
021786 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 588 78TH ST FL 2 | Brooklyn, NY 11209-3706 | 646-541-8723 |
| LOCATION | 1275 YORK AVE | New York, NY 10065-6007 | 212-639-2000 |
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