Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Gerontology
Enumerated
Feb 4, 2020
License(s)
F309352-01 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 6 S GEORGIA ST | Valley Stream, NY 11580-2309 | 917-620-9034 |
| LOCATION | 6 S GEORGIA ST | Valley Stream, NY 11580-2309 | 917-620-9034 |
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