Individual
TRACY LEE CAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2000
Mailing address
365 BOND ST APT B404, BROOKLYN, NY 11231-5166
(860) 307-8978
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F431390-1
NY
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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