Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Oct 5, 2021
License(s)
348330 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 240 E 38TH ST FL 13 | New York, NY 10016-2708 | 646-501-7521 |
| MAILING | 12 ROLLING RD | Somerset, NJ 08873-2850 | 732-841-4381 |
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.