Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Jan 14, 2013
License(s)
F337537-1 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1396 MYRTLE AVE | Brooklyn, NY 11237-4513 | 718-919-1000 |
| MAILING | 1396 MYRTLE AVE | Brooklyn, NY 11237-4513 | 718-919-1000 |
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