Individual
BRAZIL RULE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
26901 76TH AVE, NEW HYDE PARK, NY 11040-1433
(718) 470-3000
Mailing address
3139 VILLAGE DR, WAYNESBORO, VA 22980-1536
(434) 760-1413
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
031341
NY
Other
Enumeration date
02/13/2024
Last updated
02/13/2024
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