Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Apr 23, 2007
License(s)
1631551 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 888 FOUNTAIN AVE | Brooklyn, NY 11208-5907 | 718-642-3838 |
| LOCATION | 888 FOUNTAIN AVE | Brooklyn, NY 11208-5907 | 718-642-3838 |
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