Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
Jul 3, 2006
License(s)
215765 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 355 BARD AVE | Staten Island, NY 10310-1664 | 718-818-1234 |
| MAILING | 1305 WALT WHITMAN RD STE 300 | Melville, NY 11747-4300 | 516-945-3000 |
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