Individual
AYUK B ETANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1205 TROY SCHENECTADY RD STE 100, LATHAM, NY 12110-1075
(518) 348-3176
Mailing address
22 PARK LN S APT 5, MENANDS, NY 12204-1922
(518) 250-8685
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F347994-01
NY
Other
Enumeration date
10/06/2021
Last updated
10/06/2021
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