Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Aug 29, 2014
License(s)
017937 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 55 WATER STREET 2ND FLOOR CRED DEPT | New York, NY 10041-0010 | 646-680-2888 |
| LOCATION | 206-20 LINDEN BLVD | Cambria Heights, NY 11411-1524 | 718-479-6600 |
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