Individual
MS. PAMELA FRAYNA BAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1645 E 19TH ST, BROOKLYN, NY 11229-1311
(718) 265-5858
Mailing address
1645 E 19TH ST, BROOKLYN, NY 11229-1311
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
308356
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
308356
NEW YORK STATE REGISTERED NURSE PRACTITIONER LICENSE
NY
Enumeration date
08/07/2017
Last updated
03/17/2018
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