Individual
NI NI LWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8844 43RD AVE, ELMHURST, NY 11373-3445
(929) 510-3111
Mailing address
8844 43RD AVE, ELMHURST, NY 11373-3445
(929) 510-3111
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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