Individual
INES JACQUELINE CANGANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
462 1ST AVE, NEW YORK, NY 10016-9196
(212) 562-2355
Mailing address
36 DEKALB AVE, WHITE PLAINS, NY 10605-1427
(914) 681-1857
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
010991
NY
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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