Individual
CARLY WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(412) 480-1275
Mailing address
11123 75TH RD, FOREST HILLS, NY 11375-6307
(347) 417-6270
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
696519
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
310484
NY
Other
Enumeration date
08/27/2021
Last updated
10/12/2021
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