Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Dec 3, 2020
License(s)
346979 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 55 WATER ST FL 2 | New York, NY 10041-0010 | 646-680-2888 |
| LOCATION | 8831 55TH AVE STE 201 | Elmhurst, NY 11373-5293 | 718-899-6600 |
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