Individual
AERREN KUBLAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
100 E 77TH ST, NEW YORK, NY 10075-1850
(212) 434-2000
Mailing address
101 SAINT ANDREWS LN - ANNEX, ANNEX, GLEN COVE, NY 11542-2263
(516) 674-7972
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405337
NY
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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