Registry details
Type
Individual
Primary specialty
Dermatology, MOHS-Micrographic Surgery
Enumerated
Apr 2, 2015
License(s)
MD470722 (PA), MD470722 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 911 PARK AVE APT 1A | New York, NY 10075-0385 | 212-772-7724 |
| LOCATION | 1600 ST LUKES BLVD | Easton, PA 18045-5671 | 484-503-7546 |
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