Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
May 10, 2006
License(s)
142289 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 800 WOODBURY RD SUITE I | Woodbury, NY 11797-2503 | 516-364-3100 |
| LOCATION | 800 WOODBURY RD SUITE I | Woodbury, NY 11797-2503 | 516-364-3100 |
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