Individual
MS. MARY STRATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
126 5TH AVE FL 2, NEW YORK, NY 10011-5631
(646) 880-4465
Mailing address
126 5TH AVE FL 2, NEW YORK, NY 10011-5631
(646) 880-4465
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
021441
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021441
NYS PHYSICIAN ASSISTANT LICENSE
NY
Enumeration date
11/06/2017
Last updated
05/21/2020
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