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Individual

MONELLE BUISSERETH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
38 LOCUSTWOOD BLVD, ELMONT, NY 11003-1410
(516) 270-2840
Mailing address
38 LOCUSTWOOD BLVD, ELMONT, NY 11003-1410
(516) 270-2840

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
8862962
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8862962
LICENSE
NY
Enumeration date
04/07/2015
Last updated
04/07/2015
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