Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Adult Health
Enumerated
Jul 30, 2010
License(s)
F340777 (NY), F305450 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1787 MADISON AVE STE 50C | New York, NY 10035-4518 | 718-313-5209 |
| MAILING | 1727 AMSTERDAM AVE FL 4 | New York, NY 10031-4611 | 212-862-0054 |
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