Individual
DR. LETITIA WINONA SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
164 W 122ND ST APT 3, NEW YORK, NY 10027-5507
(443) 986-3001
Mailing address
164 W 122ND ST APT 3, NEW YORK, NY 10027-5507
(443) 986-3001
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
D0061184
MD
Other
Enumeration date
06/06/2007
Last updated
03/25/2019
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