Individual
ANNE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
36 CHESTNUT ST, GLEN COVE, NY 11542-1917
(917) 637-9775
Mailing address
36 CHESTNUT ST, GLEN COVE, NY 11542-1917
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
321106
NY
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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