Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Pediatrics
Enumerated
Jun 4, 2013
License(s)
382378 (NY), F382378-1 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1445 PORTLAND AVE STE 309 | Rochester, NY 14621-3008 | 585-922-4240 |
| MAILING | 601 ELMWOOD AVE BOX 656 | Rochester, NY 14642-0001 | 585-922-4240 |
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