Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jul 4, 2022
License(s)
028618 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1 CAMPUS RD | Staten Island, NY 10301-4495 | 718-390-3100 |
| MAILING | 374 STOCKHOLM ST | Brooklyn, NY 11237-4006 | 718-963-7272 |
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