Individual
MR. ABRAHAM DASALLA POTENCION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, BC
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-6134
(718) 226-6133
Mailing address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-6134
(718) 226-6133
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00115800
NJ
363LF0000X
Family Nurse Practitioner
332578
NY
Other
Enumeration date
05/17/2006
Last updated
10/10/2015
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