Individual
MRS. CARLOTTA ROSS-DISTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
13329 DENNIS ST, JAMAICA, NY 11434-4112
(347) 461-3040
Mailing address
13329 DENNIS ST, JAMAICA, NY 11434-4112
(347) 461-3040
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
016495
NY
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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