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Individual

CASSANDRA LAURENCIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RN, AGPCNP

Contact information

Practice address
1468 MADISON AVE, NEW YORK, NY 10029-6508
(212) 241-6500
Mailing address
2374 24TH ST FL 1, ASTORIA, NY 11105-3415
(646) 327-7874

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
606709
NY
363L00000X
Nurse Practitioner
Primary
309073
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
606709
REGISTERED NURSE LICENSE NUMBER
NY
Enumeration date
02/11/2019
Last updated
02/19/2019
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