Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Oct 27, 2006
License(s)
238220-1 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 363 | West Sand Lake, NY 12196-0363 | 518-367-3278 |
| LOCATION | 11 CORPORATE WOODS BLVD | Albany, NY 12211-2345 | 518-367-3278 |
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