Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Sep 7, 2017
License(s)
f342138-1 (NY), f3421381 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 241 W 57TH ST | New York, NY 10019-2121 | 866-389-2727 |
| MAILING | 241 W 57TH ST | New York, NY 10019-2121 |
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