Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Mar 20, 2007
License(s)
00005853 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 64 49 184TH ST | Freshmeadows, NY 11365 | 212-348-6410 |
| LOCATION | 2253 3RD AVE 3RD FLR | New York, NY 10035 | 212-289-6650 |
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