Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Jan 3, 2006
License(s)
155051 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 308A E 15TH ST | New York, NY 10003 | 212-505-5790 |
| MAILING | 72 EILEEN DR | Mahwah, NJ 07430-2806 | 201-327-8704 |
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