Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jan 25, 2007
License(s)
006994 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 26 OLD QUAKER HILL RD | Monroe, NY 10950-1304 | |
| LOCATION | 1400 PELHAM PKWY S | Bronx, NY 10461-1138 | 718-918-3060 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.