Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
Oct 15, 2009
License(s)
216122 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 12023 | Newark, NJ 07101-5023 | 212-427-2666 |
| LOCATION | 2510 30TH AVE ANESTHESIOLOGY | Long Island City, NY 11102-2448 | 800-627-4470 |
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