Individual
CHRYSTA VERGARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 RIVERS EDGE NEW YORK, NEW YORK, NY 10035
(646) 672-5800
Mailing address
52107 79TH ST, ELMHURST, NY 11373-4157
(347) 837-0525
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
820211
NY
Other
Enumeration date
05/30/2025
Last updated
05/30/2025
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