Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Dec 19, 2019
License(s)
—
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1075 E 51ST ST | Brooklyn, NY 11234-1620 | 347-543-4972 |
| MAILING | 1075 E 51ST ST | Brooklyn, NY 11234-1620 | 347-543-4972 |
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