Individual
MRS. EMILY KRYSTINE TAVAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
427 38TH ST, BROOKLYN, NY 11232-2514
(718) 832-9366
Mailing address
427 38TH ST, BROOKLYN, NY 11232-2514
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
382472
NY
Other
Enumeration date
10/15/2015
Last updated
10/15/2015
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