Individual
AQSA MERCHANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3636 33RD ST STE 500, LONG ISLAND CITY, NY 11106-2329
(212) 529-9780
Mailing address
3636 33RD ST STE 500, LONG ISLAND CITY, NY 11106-2329
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/06/2014
Last updated
06/06/2014
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