Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Sep 10, 2025
License(s)
F355880 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 16 LOCUST AVE APT 9P | New Rochelle, NY 10801-7370 | |
| LOCATION | 2626 HALPERIN AVE FL 1 | Bronx, NY 10461-2631 | 718-618-0401 |
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