Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Sep 10, 2014
License(s)
017915 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2126 BENSON AVE APT #1J | Brooklyn, NY 11214-5061 | |
| LOCATION | 3201 KINGS HWY | Brooklyn, NY 11234-2625 | 718-252-3000 |
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