Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Mar 18, 2024
License(s)
031597 (NY), 031597 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1 UNIVERSITY PLZ | Brooklyn, NY 11201-5301 | 973-780-7906 |
| MAILING | 138 PLENGE DR | Belleville, NJ 07109-1547 |
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