Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Jun 14, 2006
License(s)
230872 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 746087 | Atlanta, GA 30374-6087 | 312-733-9730 |
| LOCATION | 2721 BRONXWOOD AVE | Bronx, NY 10469-3642 | 718-765-6350 |
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