Individual
ETHAN SEARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
91 POPLAR AVE, BRONX, NY 10465-3943
(914) 403-1021
Mailing address
91 POPLAR AVE, BRONX, NY 10465-3943
(914) 403-1021
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
017942-1
NY
Other
Enumeration date
10/08/2014
Last updated
10/08/2014
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