Individual
HANI MEMBERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
50 COOPER SQ # B, NEW YORK, NY 10003-7108
(212) 677-3400
Mailing address
76 LOCUST DR, AMITYVILLE, NY 11701-1728
(631) 608-8384
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
012286-1
NY
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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