Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jan 11, 2010
License(s)
013482 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 15 WESTMINSTER RD APT 3H | Brooklyn, NY 11218-2853 | 949-910-7276 |
| LOCATION | 17 BRISTOL ST | Brooklyn, NY 11212-5629 | 718-495-8160 |
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