Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Mar 24, 2007
License(s)
R193401 (MD), LG0000590 (DE), 337678 (NY), RN 268422 (MA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 35 E 21ST ST | New York, NY 10010-6212 | 212-530-0659 |
| LOCATION | 35 E 21ST ST | New York, NY 10010-6212 | 212-530-0659 |
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