Individual
CONNIE M POUPORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16 SCHOOL ST, MOOERS, NY 12958-4223
(518) 236-5201
Mailing address
PO BOX 277, MOOERS, NY 12958-0277
(518) 236-5201
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
367942-1
NY
Other
Enumeration date
10/06/2017
Last updated
10/06/2017
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