Individual
MRS. JEROY S MOTSIFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.N.P.
Contact information
Practice address
33 GILBERT ST, SUITE 3, CAMBRIDGE, NY 12816-2643
(518) 677-8575
(518) 677-2580
Mailing address
614 TURNPIKE RD, BUSKIRK, NY 12028-2521
(518) 677-3597
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
380744
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01614819
—
NY
Enumeration date
01/13/2006
Last updated
01/05/2012
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