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Individual
MARY GAYNOR
Active
Individual
MARY GAYNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
630917
NY
363LF0000X
Family Nurse Practitioner
F338183
NY
Other
Enumeration date
07/12/2013
Last updated
04/07/2016
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