Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Mar 31, 2007
License(s)
011519 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 972 BRUSH HOLLOW RD | Westbury, NY 11590-1740 | 516-876-5555 |
| LOCATION | 101 SAINT ANDREWS LN | Glen Cove, NY 11542-2254 | 516-674-7591 |
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