Individual
HIRA MARIE GAMALE PANTANOSAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
622 W 168TH ST PH 3-303, NEW YORK, NY 10032-3720
(212) 305-2677
Mailing address
4825 43RD ST APT 5J, WOODSIDE, NY 11377-6836
(718) 391-0095
(718) 391-0095
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F430035-01
NY
Other
Enumeration date
07/15/2006
Last updated
08/24/2022
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