Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Apr 30, 2012
License(s)
274040-1 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 46 COTTAGE ST APT C | Port Chester, NY 10573-5174 | 914-255-0706 |
| LOCATION | NYU LANGONE MEDICAL CENTER 550 1ST AVE | New York, NY 10010 | 212-263-5250 |
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