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Individual

MS. KATHY LA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-6846
Mailing address
173 AVENUE B, APT. 1A, NEW YORK, NY 10009-4656
(917) 554-1740

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
23017327
NY

Other

Enumeration date
04/27/2014
Last updated
04/27/2014
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