Individual
CHLOE PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3 W 108TH ST APT 16, NEW YORK, NY 10025-3378
(917) 488-0561
Mailing address
3 W 108TH ST APT 16, NEW YORK, NY 10025-3378
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1889609
NY
Other
Enumeration date
06/19/2012
Last updated
06/19/2012
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