Individual
KRYSTEN VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS, RPAC
Contact information
Practice address
3716 108TH ST, CORONA, NY 11368-2025
(718) 651-4000
Mailing address
3716 108TH ST, CORONA, NY 11368-2025
(718) 651-4000
(718) 424-7776
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
020916
NY
Other
Enumeration date
05/04/2017
Last updated
07/19/2017
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