Individual
MRS. JOAN GORHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AOCNP, MSN
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-6920
Mailing address
1606 AVALON PINES DR, CORAM, NY 11727-5141
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
306300
NY
Other
Enumeration date
01/04/2013
Last updated
01/04/2013
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