Individual
MARIA KRYSTLE GLAZE FAVORITO ROLDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
506 6TH ST, BROOKLYN, NY 11215-3609
(718) 780-3000
Mailing address
277 E 4TH ST APT 1C, NEW YORK, NY 10009-7527
(212) 470-5003
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
307538
NY
Other
Enumeration date
06/08/2018
Last updated
06/08/2018
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