Individual
MIKEL ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGNP-BC
Contact information
Practice address
345 E 68TH ST APT 4B, NEW YORK, NY 10065-5629
(314) 302-7369
Mailing address
345 E 68TH ST APT 4B, NEW YORK, NY 10065-5629
(314) 302-7369
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F308795
NY
Other
Enumeration date
08/03/2018
Last updated
08/03/2018
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