Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
May 4, 2007
License(s)
0065381 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 957 CEDARHURST ST | Valley Stream, NY 11581-2716 | 516-295-2022 |
| LOCATION | 1ST AVE & 27TH STREET | New York, NY 10016 | 212-562-3776 |
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