Individual
ANNA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4004 BOWNE ST APT 1I, FLUSHING, NY 11354-6129
(718) 539-3359
Mailing address
2276 41ST ST APT 3A, ASTORIA, NY 11105-1723
(831) 420-7509
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
309359
NY
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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