Individual
MRS. JACQUELINE MARIE KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7901 BROADWAY ANEX O 3RD FLOOR, ELMHURST, NY 11373
(718) 334-3148
Mailing address
1 BARBERRY LANE, SEA CLIFF, NY 11579
(516) 674-4914
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F306406-1
NY
Other
Enumeration date
09/10/2013
Last updated
09/10/2013
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