Registry details
Type
Individual
Primary specialty
Physician Assistant, Surgical
Enumerated
Jan 9, 2017
License(s)
024459 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 535 E 70TH ST | New York, NY 10021-4898 | 212-606-1000 |
| MAILING | 535 E 70TH ST | New York, NY 10021-4898 |
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